Snakes in Australia and New Guinea are quite toxic but fortunately fatalities are rare if proper care is given.
Risk factors and indicators for severe envenomation:
(1) multiple bites
(2) alcohol intoxication
(3) early onset of paralytic signs (starting with ptosis, blurred vision, diplopia, and/or dysarthria)
(4) early onset of coagulopathy
(5) early onset of myolysis with myoglobinuria
(6) convulsions
Early collapse alone does not predict severe envenomation.
A patient with severe envenomation should receive antivenom.
The absence of symptoms at 6 hours after the bite usually indicates that a severe envenomation is unlikely. However, a person who has received first aid with limb immobilization may have a delay in symptom onset. Therefore, the patient should be kept for observation for 24 hours to detect delayed onset of paralysis.
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