Journal article

Delayed antivenom for life-threatening tiger snake bite: Lessons learnt

James Tibballs, Andrew M Padula, Kenneth D Winkel, Hamish D Jackson

Anaesthesia and Intensive Care | SAGE PUBLICATIONS LTD | Published : 2020


An adolescent victim of an urban snakebite developed respiratory failure, rhabdomyolysis and consumption procoagulopathy but recovered with two vials of tiger snake antivenom administered after a delay of 48 hours. The clinical significance of a post-bite collapse was not initially appreciated. Tiger snake (Notechis spp.) venom antigen was measurable in blood before antivenom but not after whereas antivenom was measurable in blood for nine ensuing days. This case adds to growing evidence that further pharmacokinetic research of venom-antivenom interaction is required to establish the correct dose and timing of tiger snake antivenom. Antivenom therapy, even when delayed, facilitates recovery ..

View full abstract


Funding Acknowledgements

We thank the Australian government's National Health and Medical Research Council for funding support to Dr Winkel and Seqirus for funding support to the Australian Venom Research Unit medical advisory service at the time of this case. None of these organisations had any role in the analysis or write up of this case.