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Snakes, why did it have to be snakes?

Dr Nick Erskine

Emergency Registrar

Peer review / Editor: Dr Hector Thomson | Dr David McCreary

I grew up in New Zealand and therefore snakebites were never something that particularly crossed my mind. I was far more afraid of falling into quicksand or tripping a yellow barrel of radioactive green sludge than I was of creepy crawlies.

However, since migrating across the ditch, my need to fear and understand venom-induced consumptive coagulopathies has grown. In fact, diving into toxinology study may have well driven me back to the safety of New Zealand if not for the discovery of a cannibalistic New Zealand sea-slug that’s riddled with tetrodotoxin.

Let’s talk about Snakes, baby

Despite Australia’s reputation for being fraught with deadly animals, snake bites are a relatively rare event here. Exact estimates vary, but the incidence is in the ballpark of 3 envenomations per 100,000 people per year.[1, 2]

Importantly, most snakebites in Australia do not result in envenomation [3]. This may either be from a non-venomous snakebite, or from a “dry bite” by a venomous snake where insufficient venom is injected to cause envenomation in a person.

Whilst there are dozens (and dozens and dozens!) of different snakes in Australia the big ones we are concerned about when it comes to envenomation are

Black Snake Group (Pseudochis)

Brown Snake (Pseudonaja)

Death Adder (Acanthophis)

Sea Snake (Hydrophiliadae)

Taipan Snake (Oxyuranus)

Tiger Snake Group (Notechis)

It is rare that someone can reliably tell you which snake bit them (snake handlers undergoing workplace accidents excepted). We all know of cases where malicious sticks on the ground have stabbed someone in the ankle whilst an innocent snake happened to be nearby.

Rather than relying on the patient’s blurred description of colours and patterns, take guidance from the environment around you and the toxidrome before you.