To the Editor: We read the perspective by Weinstein and colleagues1 with interest and agree that treatment of snake envenoming in Australia is complex, and that clinicians should seek expert advice in cases of severe or unusual envenoming. There is 24‐hour specialist clinical toxicologist support available through the national Poisons Information Centre network (13 11 26), which takes 300 calls annually regarding snakebite.
- 1. Weinstein SA, Mirtschin PJ, White J. Risks and realities of single vial antivenom recommendations for envenoming by Australian elapid snakes. Med J Aust 2019; 211: 492–493. https://www.mja.com.au/journal/2019/211/11/risks-and-realities-single-vial-antivenom-recommendations-envenoming-australian.
- 2. Johnston CI, Ryan NM, Page CB, et al. The Australian Snakebite Project, 2005–2015 (ASP‐20). Med J Aust 2017; 207: 119–125. https://www.mja.com.au/journal/2017/207/3/australian-snakebite-project-2005-2015-asp-20.
- 3. Johnston CI, Ryan NM, O'Leary MA, et al. Australian taipan (Oxyuranus spp.) envenoming: clinical effects and potential benefits of early antivenom therapy – Australian Snakebite Project (ASP‐25). Clin Toxicol (Phila) 2017; 55: 115–122.
- 4. O'Leary MA, Maduwage K, Isbister GK. Detection of venom after antivenom administration is largely due to bound venom. Toxicon 2015; 93: 112–118.
- 5. eTG Complete. Snake bite. In: Toxicology and toxinology [In press]. Melbourne: Therapeutic Guidelines Limited, 2020. https://www.tg.org.au.
- 6. O'Leary MA, Isbister GK. Commercial monovalent antivenoms in Australia are polyvalent. Toxicon 2009; 54: 192–195.
Publication of your online response is subject to the Medical Journal of Australia's editorial discretion. You will be notified by email within five working days should your response be accepted.