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Antivenom: Polyvalent

Presentation

46-50mL vial

*KEEP REFRIGERATED*

Contains

  • 18000   units Black Snake Antivenom
  • 12000   units Taipan Antivenom
  •  6000    units Death Adder Antivenom
  •  3000    units Tiger Snake Antivenom
  •  1000    units Brown Snake Antivenom
Polyvalent snake antivenom

Role

  • To treat envenomation by taipan, black snake (excluding red bellied black snake – See Tiger Snake Antivenom fact sheet) and death adder.
  • If specific monovalent antivenoms unavailable to treat envenomation by brown snakes, tiger snakes and red bellied black snake.
  • Treatment of severe envenomation when the causative snake is unknown.
  • ALERT – Consultation with a clinical toxicologist is recommended through local toxicology service or Poisons Information Centre 13 11 26.

Dose

1 vial IV administered over 15 min following a 1:10 dilution with sodium chloride 0.9%. Dilution can be 1:5 in young children or patients on fluid restriction.

Stocking recommendations

Tertiary centre Regional centre Rural centre Remote centre
2 vials 1 vial 1 vial 1 vial

Rationale

Polyvalent antivenom is the preferred first line option for the management of envenomation due to black snakes, death adder and taipan.  These snakes account for a small number of severe envenomations in most parts of Australia and holding separate monovalent antivenoms for these species is impractical. In smaller centres where snake envenomation is uncommon, stocking a single vial of polyvalent to treat any snake envenomation is the most logical approach.

Precautions

  • Hypersensitivity reactions may occur. Antivenom should be administered in a critical care area in anticipation of potential anaphylaxis.
  • Premedication with steroids/adrenaline is not recommended.
  • If a hypersensitivity reaction occurs, pause the infusion and treat along standard lines.  Recommence the infusion once the reaction settles at a slower rate.
  • If the hypersensitivity reaction is severe, discuss the case with a clinical toxicologist.

Serum sickness may occur 4 to 14 days following the administration of antivenom. Symptoms include fever, rash, joint and muscle pain, headache, nausea and vomiting.  Patients should be informed of the symptoms and present to their local doctor should they occur.

Disclaimer

Fact sheet developed by Queensland Poisons Information Centre, Updated: July 2020.

This fact sheet is about the use of these antidotes in Australia, and may not apply to other countries. Children’s Health Queensland Hospital and Health Service cannot be held responsible for the accuracy of information, omissions of information, or any actions that may be taken as a consequence of reading this fact sheet.

CHQ