G'day all,
There's a little bit of misinformation with regards to antivenom in the last couple of pages.
Here's a thread I posted a couple of years ago that may be of interest -
http://www.aussiepythons.com/forum/australian-snakes-37/snakebite-fatality-information-89473/
A small adder like that still carries enough venom to drop a healthy adult male with ease. A lot of people disregard juvenile adder bites as insignificant, and it will result in a tragedy one day. They can, and still do, kill people.
The doctor's inexperience with regards to snakebite treatment is not surprising. I have been to hospital twice for snakebite (G'day Ray), and both times the nurses or doctors have made mistakes that could potentially be life threatening if I was in a bad way. It is the keepers responsibility to have a thorough snakebite management plan, which should include information such as emergency contact numbers (for example, the AVRU), correct first aid treatment from immediately post bite right through to antivenom therapy etc. It is also the keepers responsibity to liase with local hospitals to ensure they stock appropriate antivenom, especially if you are regional.
Treating the bite properly immediately post bite generally won't have any effect on antivenom requirements later on. You will require antivenom if you are showing significant systemic symptoms (i.e. Several bad things happening at once). For a minor bite, they will just treat the minor symptoms individually. Correct first aid simply delays the onset of symptoms until you are in hospital, where they can have some form of control over them.
Antivenom is a heavily controlled drug, and cannot legally be kept by a keeper. It is only administerable by a doctor. With correct first aid, there is no need to have antivenom on hand. It generally has a use-by period of 3 years.
Polyvalent isn't a magic "get out of jail free card" - if it were, they wouldn't bother with any of the monovalent antivenoms. It is a last minute resort to stop someone dying, and generally comes with some nasty side effects.
The reason they don't use the CSL polyvalent antivenom in Victoria is because there are only two immunogroups that could cause a life-threatening bite (whilst if you were within 100km of Cairns, it could be any of the 5 terrestrial immunogroups). There are no Taipans, Adders, Mulga's etc in Victoria. The single
Pseudechis species that occurs there is treated with Tiger Snake antivenom (but not all
Pseudechis are treated with Tiger), as are Tigers and Copperheads. There are two species of
Pseudonaja, both of which are treated with Brown antivenom.
Venom Detection Kits are an absolute God send. They don't tell you what species of snake bit you, they tell you what is the most effective antivenom to use if required. They aren't perfect, hence why three of them should be used before administering antivenom (to eliminate false positives), but they have undoubtedly saved hundreds of lives.
They work by adding a sample of the venom (generally via a swab of the bite site) to a series of different indicators - which ever shows up positive will indicate what antivenom to use. Depending on your location in Australia, this can sometimes tell you what species you were bitten by. For example, if you showed up positive for Tiger Snake on the Eyre Peninsula in South Australia, you were bitten by a Tiger...but if you showed up positive for Brown Snake on the Eyre, it could have been on of 3 species. But if you showed up positive for Tiger in Byron Bay in New South Wales, it could have been a host of species...but positive for Brown will be an Eastern Brown.