Hawdon G M, Winkel K D
Australian Venom Research Unit, Cabrini Private Hospital.
Aust Fam Physician. 1997 Dec;26(12):1386-91, 1393-4.
Australian snakes are among the most venomous in the world. Although usually obvious, the occurrence of snakebite is occasionally unrecognised by the patient and/or physician, resulting in delayed or inadequate treatment, or even in death.
This article describes the historical, clinical and pathologic features associated with envenomation by various Australian venomous snakes, and discusses the investigation and management (including first aid) of suspected snakebite.
A high index of suspicion should be maintained, particularly in rural areas and in patients unable to give a history. Investigations including creatine kinase, clotting profile and venom detection kit should be performed in cases of suspected snakebite. The choice of appropriate antivenom and its indications are discussed.
澳大利亚的蛇类是世界上毒性最强的蛇类之一。虽然蛇咬伤通常很明显，但患者和/或医生偶尔会未识别出蛇咬伤情况，从而导致治疗延迟或不充分，甚至导致死亡。
本文描述了各种澳大利亚毒蛇咬伤中毒的历史、临床和病理特征，并讨论了疑似蛇咬伤的调查与处理（包括急救）。
应保持高度的怀疑指数，尤其是在农村地区以及无法提供病史的患者中。对于疑似蛇咬伤病例，应进行包括肌酸激酶、凝血指标和毒液检测试剂盒在内的检查。文中讨论了合适抗蛇毒血清的选择及其适应证。
