# Police race anti-venom to victim



## Fuscus (Nov 3, 2011)

Police race anti-venom to victim | Sunshine Coast News | Local News in Sunshine Coast | Sunshine Coast Daily


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## Bel03 (Nov 3, 2011)

Probaly a stupid question, but how do they know what anti venom to use if they dont know what snake it was? I thought it would be a different anti venom for each breed?


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## Wild~Touch (Nov 3, 2011)

venom detection kit CSIRO


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## waruikazi (Nov 3, 2011)

Or use polyvalent AV.


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## Vegez (Nov 3, 2011)

Unidentified bites are determined with the VDK (as mentioned above), there is also a polyvalent antivenom which is effective against most of the medically significant genera.

If the species proves to be P. textilis, there is a very worrying trend starting to form here. For some unknown reason, people envenomated by P. textilis primarily from Qld, tend to respond poorly to antivenom therapy when compared to treatment stats for Vic or NSW. There may be a cryptic species involved here? Another explanation could be that P. textilis from some Qld populations are feeding on a particular (different) kind of prey that has resulted in some molecular change in the venom, and thus the antivenom doesn't bind as effectively.
Certainly an area that needs to be investigated.
Cheers all.


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## Bel03 (Nov 3, 2011)

^^^ Thanks for the replies.......but i havent looked into anything about anti venom etc, so i have no idea what you both have said!  Im guessing though that you both have said that it doesnt matter if the snake is unknown, there is still anti venom that works?

Thanks Vegaz, i had posted before i read your reply. Would the vdk show what snake it was though?


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## waruikazi (Nov 3, 2011)

Vegez do you have any further reading on that?


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## waruikazi (Nov 3, 2011)

Bel711 said:


> ^^^ Thanks for the replies.......but i havent looked into anything about anti venom etc, so i have no idea what you both have said!  Im guessing though that you both have said that it doesnt matter if the snake is unknown, there is still anti venom that works?



Pretty much Bel.

Polyvalent AV is basically lots of different types of AV all mixed up into the one vial, hence the name POLYvalent. As opposed to MONOvalent AV which is made to work most effectively on one type of venom.


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## Wild~Touch (Nov 3, 2011)

textillis seem to do well here in SE Qld.

A magnificent specimen was mutilated by the local heroes right before my eyes recently, it appeared to be near 6 ft. if not over

shame on me but I'm not a venomous snake catcher


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## Vegez (Nov 3, 2011)

Hey Gordo,
This is actually the project I'm currently working on. I have accessed hospital records from across eastern Australia, and this is where I noticed a trend.

For example, around this time last year, there were 2 fatalities in SE Qld from textilis bites. What was probably the most disturbing aspect is one of the victims died 5 days after treatment. In another case, mid-coast Qld, one victim received a record 17 ampoules of mono AV.

When the paper is in draft form, I'm more than happy to email you a copy.

All the Best.


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## waruikazi (Nov 3, 2011)

That would be great vegez, i appreciate the offer. It's good to know the DSE and parks authorities are working with you on this one


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## her_xr6t (Nov 3, 2011)

Hmmm,
I'm moving to Warwick today, best I update my first aid skills and first aid box.


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## PMyers (Nov 3, 2011)

Vegez said:


> Another explanation could be that P. textilis from some Qld populations are feeding on a particular (different) kind of prey that has resulted in some molecular change in the venom, and thus the antivenom doesn't bind as effectively.



Bloody cane toads!


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## prettypython (Nov 3, 2011)

Terrible sad news that the woman past away. I would hope this helps somehow, maybe an inquest or simular as to why a hospital would only have one vile of anti venom and the snake was not identified through vdk or blood or urine sample. 

Doesn't seem right, could just be a bad media report though.


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## tsbjd (Nov 3, 2011)

And why does everyone hate DSE and parks - you should be helped out instead of getting in bloody trouble! I have a limited knowledge on the subject, but has the QLD variant developed / evolved to have a immunity to the cane toad, and as suched changed their venom,or is it something else?


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## prettypython (Nov 3, 2011)

her_xr6t said:


> Hmmm,
> I'm moving to Warwick today, best I update my first aid skills and first aid box.



Just because you will live in the same town that a woman recived a fatal bite, does not increses your risk of being biten.
wonderful idea though to brush up on snake bite first aid and keep a few broad bandages with you as not one australian has died from a elapid envenomation that has applied correct first aid.

Goodluck with your move


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## Wild~Touch (Nov 3, 2011)

I like AVRU snakebite 1st aid instructions .. print it out and learn it and practice bandaging ... could save a life or buy you time

ever tried to apply a bandage when you panicking ? if you're a confident bandager then you're better off


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## Wild~Touch (Nov 3, 2011)

prettypython said:


> Terrible sad news that the woman past away. I would hope this helps somehow, maybe an inquest or simular as to why a hospital would only have one vile of anti venom and the snake was not identified through vdk or blood or urine sample.
> 
> Doesn't seem right, could just be a bad media report though.




Antivenom is quite expensive and it has a reasonably short shelf life

Usually antivenom can only be administered if the hospital has an ICU


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## prettypython (Nov 3, 2011)

I didn't know that anti venom could only be given if ICU was avalible, I always thought that only the pressure bandage could not be removed with out ressusitation gear, and that addrenline had to be drawn up as anaphalactic shock from equine by product was high.

I've learnt something new today.


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## Jonno from ERD (Nov 3, 2011)

Vegez said:


> Unidentified bites are determined with the VDK (as mentioned above), there is also a polyvalent antivenom which is effective against most of the medically significant genera.
> 
> If the species proves to be P. textilis, there is a very worrying trend starting to form here. For some unknown reason, people envenomated by P. textilis primarily from Qld, tend to respond poorly to antivenom therapy when compared to treatment stats for Vic or NSW. There may be a cryptic species involved here? Another explanation could be that P. textilis from some Qld populations are feeding on a particular (different) kind of prey that has resulted in some molecular change in the venom, and thus the antivenom doesn't bind as effectively.
> Certainly an area that needs to be investigated.
> Cheers all.




*All* bites are identified with a VDK, regardless of whether the species is known or not.

It's interesting to hear that SE QLD _P.textilis _bites don't respond as well to antivenom as other localities. It's no secret that SE QLD _P.textilis _are generally considerably more venomous than southern animals, but SE QLD animals are on the antivenom program at ARP and therefore whatever components are in their venom would be represented in the appropriate antivenom. I know there was a situation that was blown out of proportion with regards to _P.affinis_ responding poorly to antivenom a couple of years ago.

17 vials of antivenom screams doctor incompetence, too.


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## Vegez (Nov 3, 2011)

Spot on Jonno, all bites are confirmed by VDK.

It is interesting the P. textilis Qld is represented in th AV Program and yet still there are cases of this "poor" response.

Definately worth a bit of investigation.

Cheers all.


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## Wild~Touch (Nov 3, 2011)

I've learnt something new today. That's good prettypython

Never stop learning 

I find the subject quite fascinating


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## jedi_339 (Nov 3, 2011)

I'd love to read your work Vegez whether in draft form, or when published, sounds like a fascinating study you're involved in, have you any idea how long until completion? About the article, I don't believe I read anywhere in there about the initial first aid the woman received on her property, if she were away from the house or even if she didn't receive pressure immobilisation of the bite area initially then her chances of recovery may well have been significantly reduced. Always unfortunate though.


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## Jonno from ERD (Nov 3, 2011)

G'day Vegez,

I'd hazard a guess that the "poor response" to Brown Snake antivenom is attributable to the doctors poor understanding of how it works. I've discussed this previously with Dr Bill Nimo from the AVRU and it's generally a case of doctors trying to reverse symptoms and effects when the only option is to let the body replenish the resources itself. I think you'd gain a lot of knowledge from talking with Bill - you can get in touch with him via the AVRU website.


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## mmafan555 (Nov 4, 2011)

Vegez said:


> Unidentified bites are determined with the VDK (as mentioned above), there is also a polyvalent antivenom which is effective against most of the medically significant genera.
> 
> If the species proves to be P. textilis, there is a very worrying trend starting to form here. For some unknown reason, people envenomated by P. textilis primarily from Qld, tend to respond poorly to antivenom therapy when compared to treatment stats for Vic or NSW. There may be a cryptic species involved here? Another explanation could be that P. textilis from some Qld populations are feeding on a particular (different) kind of prey that has resulted in some molecular change in the venom, and thus the antivenom doesn't bind as effectively.
> Certainly an area that needs to be investigated.
> Cheers all.



Easy explanation...Snake venom varies based on location in the SAME snake...An eastern brown from South Australia would have a different venom composition/toxicity than an Eastern Brown from Queensland...This is probably true for most if not all venomous snakes


Apparently the eastern browns from Queensland are significantly more toxic than the eastern browns from South Australia

*Comparison of active venom components between Eastern brown snakes collected from South Australia and Queensland.*

_Abstract:_

"The abundance and activity of the prothrombin activator (pseutarin C) within the venom of the Eastern brown snake (Pseudonaja textilis textilis) is the primary determinant of its coagulation potency. Textilinin-1, also in this venom, is a plasmin inhibitor which is thought to exert its toxic effects through the slowing of fibrinolysis. The aim of this report is to determine if there are differences in the potency of the venom from Eastern brown snakes collected from South Australia (SA) compared to those from Queensland (QLD). A concentration of 0.4 microg/ml venom protein from six QLD specimens clotted citrated plasma in an average time of 21.4+/-3.3 s compared to 68.7+/-2.4 s for the same amount of SA venom (averaged for six individuals). The more potent procoagulant activity of the QLD venom was measured between 0.4 and 94 microg/ml venom protein in plasma. The anti-plasmin activity of textilinin was also greater in the venom of the snakes collected from QLD, causing full inhibition of plasmin at approximately 1.88 microg/ml of venom protein compared to approximately 7.5 microg/ml for the SA venoms. It is concluded that geographic differentiation of the Eastern brown snakes results in significant differences venom potency."

Heres the link to the whole study
SpringerLink - Ecotoxicology, Volume 15, Number 2

And the eastern browns from Queensland [near the Gold Coast Region] also had a significantly larger venom yield than the ones from South Australia[ Barossa Valley and Adelaide
regions]. The Queensland browns were also larger in body size than the South Australian browns. 

Venom potency and yield for a given snake changed throughout the year from both regions. Their was also evidence that a snakes venom increases in potency if the snake has not had a meal for awhile. Mice were used as test animals for the venom 

​


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## Vegez (Nov 4, 2011)

Thank you mmafan555 for your input. I am aware of the study you mentioned above re: faster clotting times & larger yields in some Qld populations of P. textilis.

The easy explanation certainly tells us what we could expect, however, I'm more interested in the "why" behind this. Are there certain environmental issues at play here? What "forces/pressures or mechanisms" are involved here.

Although there is great gepgraphic variation seen in many venomous snakes, there are also examples that go the other way. For example, one of our most widely distributed species, Pseudechis australis, shows little to no variation in venom composition even though their distribution covers much of the country.

I appreciate your help, but I still believe there are many questions in this area that remain unanswered.

All the Best.


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## -Peter (Nov 4, 2011)

Vegez said:


> Spot on Jonno, all bites are confirmed by VDK.
> 
> It is interesting the P. textilis Qld is represented in th AV Program and yet still there are cases of this "poor" response.
> 
> ...



I can vouch for one very recent instance where a VDK was not used and antivenom administered. It was quite obvious that envenomation had taken place and that the "victim" was able to fully identify the snake and thats the call the toxinocologist made.

In regards to the changes in P.textilis venom, I think David Williams made mention of that during his AHS talk the other month. I would love to know more when the info comes available.


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