Abstract

Brown snakes are the leading cause of snakebites and snakebite fatalities in Australia and the incidence may be rising. Most fatalities are the result of early events after the bite, often a general or cardiac collapse. Lack of appropriate first aid is a common finding. It is probable that an early thrombotic effect of venom procoagulants, prior to defibrination, is responsible for the cardiac collapse in most of these cases. CSL brown-snake antivenom, while not perfect, is usually effective if given in sufficient quantity, but cannot reverse established vital-organ damage. Increased public education about the danger of snakebite and correct first aid may reduce the death toll, and improved professional continuing education on snakebite is advisable but, ultimately, some brown-snake bite deaths are probably inevitable, despite optimum medical care.

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