Prompt

Adult with pressure immobilisation bandage after an unidentified snakebite develops laboratory VICC and early cardiovascular instability.

Station brief

Format. Clinical-management (resus) station, 11 minutes — 4 minutes reading, 7 minutes active management. You are the EM consultant.

Candidate instructions. Manage from trolley handover. State actions and reasoning aloud. Examiner plays nursing/pharmacy. ^[1]

References3Show

[1]Johnston CI, Ryan NM, Page CB, et al. The Australian Snakebite Project, 2005-2015 (ASP-20). Med J Aust, 2017.PMID 28764620
[2]Isbister GK, Brown SG, MacDonald E, et al. Current use of Australian snake antivenoms and frequency of immediate-type hypersensitivity reactions and anaphylaxis. Med J Aust, 2008.PMID 18429716
[3]de Silva HA, Pathmeswaran A, Ranasinha CD, et al. Low-dose adrenaline, promethazine, and hydrocortisone in the prevention of acute adverse reactions to antivenom following snakebite: a randomised, double-blind, placebo-controlled trial. PLoS Med, 2011.PMID 21572992

Station brief

Format. Clinical-management (resus) station, 11 minutes — 4 minutes reading, 7 minutes active management. You are the EM consultant.

Candidate instructions. Manage from trolley handover. State actions and reasoning aloud. Examiner plays nursing/pharmacy. ^[1]

References3Show

[1]Johnston CI, Ryan NM, Page CB, et al. The Australian Snakebite Project, 2005-2015 (ASP-20). Med J Aust, 2017.PMID 28764620
[2]Isbister GK, Brown SG, MacDonald E, et al. Current use of Australian snake antivenoms and frequency of immediate-type hypersensitivity reactions and anaphylaxis. Med J Aust, 2008.PMID 18429716
[3]de Silva HA, Pathmeswaran A, Ranasinha CD, et al. Low-dose adrenaline, promethazine, and hydrocortisone in the prevention of acute adverse reactions to antivenom following snakebite: a randomised, double-blind, placebo-controlled trial. PLoS Med, 2011.PMID 21572992

Snake envenomation — unidentified bite resus station