Antivenom update

Recent research has found that one vial of antivenom is sufficient for the treatment of envenomation by all five major groups of Australian snakes. In snake bite coagulopathy, serial coagulation testing helps determine when patients can be safely discharged, but abnormal results are not an indication for further antivenom. Clinically significant rhabdomyolysis is more common than previously realised in red-bellied black snake envenomation. Early antivenom administration may prevent rhabdomyolysis, but it is unclear if this benefit outweighs the risk of adverse reactions to antivenom. Analgesia is the mainstay of treatment for redback spider bite. Early and effective cardiopulmonary resuscitation is more important than antivenom in box jellyfish envenomation.