CSL Antivenom Handbook

Medical Treatment of Bites and Stings

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General Principles

Bites/stings by some animals are potentially lethal, such as snakebite, funnel web spider bite, paralysis tick bite, blue ringed octopus bite, cone shell sting and box jellyfish sting. Any patient presenting with a possible or definite bite/sting by these organisms should be given high priority in triage and assessed as quickly as possible.

In some cases a delay of even minutes may be crucial in affecting outcome.

Bites/stings by some other animals, notably the red back spider, stonefish, and stingrays may result in severe problems, equally demanding urgent attention.

Diagnosis of bites and stings may be straightforward, but often is less than easy, and occasionally quite difficult. In the latter case, rapid accurate diagnosis may be critical to the outcome for the patient and this requires doctors to maintain a high index of suspicion for envenoming in certain situations. This will be discussed more fully below (section on "Diagnosis").

Where available, antivenom is virtually always the best treatment for envenoming, but is usually only needed if there is significant systemic envenoming. Not every snake bitten patient needs antivenom!

Never assume that medical or nursing staff know what to look for in observing a patient with envenoming. Instruct them on what to look for, particularly specific signs, such as ptosis, dysarthria and weakness (ie paralysis in snakebite, blue ringed octopus bite and tick bite), persistent bleeding from bite site or venepuncture wounds (ie coagulopathy in snakebite), dark urine due to myoglobin (ie myolysis) or haematuria in snakebite, profuse sweating (ie red back spider bite), profuse salivation, lachrymation and piloerection with muscle twitching (ie funnel web spider bite). Frequent detailed and specific observations are the rule for most cases of possible envenoming.

Any bite may be the source of secondary infection and this may include tetanus, so ensure tetanus prophylaxis and watch for developing cellulitis.



Snake Venom Detection


Spiders and Other Arthropods

Marine Animals