The treatment of snake-bite in Australia / Department of Health, Commonwealth Serum Laboratories.

Date:
1931
Catalogue details

Licence: In copyright

Credit: The treatment of snake-bite in Australia / Department of Health, Commonwealth Serum Laboratories. Source: Wellcome Collection.

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    symptoms 24 hours after being bitten; the administration of 4,500 units of antivenene intravenously and a further 3,000 units intramuscularly (to maintain a high concentration of antivenene in the blood) was followed by a dramatic recovery. Therefore, one should not despair of any victim of tiger snake bite, but should begin treatment with antivenene as soon as possible. - The subcutaneous administration of antivenene is of little value, since the absorption rate of serum is so much slower than that of the rapidly diffusible snake poisons. A number of persons are hypersensitive to horse serum, and in such cases rapid intravenous injections of serum may cause acute anaphylactic shock. There may or may not be a history to guide one of attacks of asthma or hay fever, or of having received previous injections of serum. Horse asthmatics are particularly prone to react dangerously following the injection of horse serum. It is much safer, therefore, to test the patient before giving an intravenous dose by injecting intradermally 0°1 cubic centimetre of diluted horse serum. This may be prepared rapidly by adding one part of serum to nine parts of sterile normal saline solution, mixing well, and injecting one-tenth of a cubic centimetre of the diluted serum into the skin. A control injection is made of 0°! cubic centimetre of normal saline solution prior to giving the diluted serum. Wheals are produced at the site of injection in both cases ; that produced by the salt solution disappears in the course of a few minutes. __If the patient is not hypersensitive, the wheal produced by the serum fades almost as quickly. If a positive result to the test is obtained, a genuine urticarial wheal appears which may increase in size and be surrounded by an area of erythema. Itching frequently accompanies a positive reaction. It should be possible to determine within twenty minutes of the injection what type of reaction the patient will give. Should the patient prove hypersensitive to serum, it is dangerous to give serum intravenously without first de- sensitizing the patient. Todo this, an initial dose of 0°025