Snake envenomation — antivenom and VICC viva

Syndrome. Laboratory pattern of extreme consumptive coagulopathy with preserved platelets is VICC, not DIC. Brown snake is the classic isolated-VICC culprit; tiger/taipan add neurotoxicity and myolysis — examine for ptosis and track CK.^[1]

First aid. Pressure immobilisation bandage of the entire limb + immobilisation. Leave it on until antivenom ready. SVDK guides monovalent choice but clinical syndrome and geography can override. ^[1]

Antivenom. Indicated for any systemic envenomation. Unidentified snake → polyvalent; identified group → monovalent (brown 1–2 vials; tiger 2–4 vials commonly). IV diluted infusion; adrenaline 0.25 mg subcutaneous premedication (randomised-trial regimen; severe reactions reduced 43 per cent at 1 hour); monitored area.^[1][2][3]

Blood products. Only if bleeding, after antivenom. Factors first are re-consumed. ^[1]

Neurotoxic patterns. Presynaptic (tiger/taipan) paralysis is poorly reversible — intubate early for bulbar failure. Death adder postsynaptic paralysis may respond to antivenom ± neostigmine bridge. ^[1][4]