====== The Australian Snakebite Project ======

The Australian Snakebite Project (ASP) is a multi centre project which set out to collect prospective data on presumed and definite snakebite victims regardless of whether envenomed or not. Data from ASP has been recorded from greater than 100 hospitals within Australia. As a result the evidence basis for management decisions in snakebite has increased immensely.

As well as demographic and clinical information, venom specific enzyme immunoassays were developed for a number of common snake groups. This allowed individual envenomed cases to be definitively identified as envenomed by a specific snake group by virtue of an assay showing a serum level consistent with envenoming. In cases where blood sampling was done before and after administration of anti venom (AV), this provided information on how useful AV was in removing toxic venom by virtue of whether venom was still present post AV and how much AV had been used. Additionally other less well described groups of snakes such as rough-scaled snakes, have had their clinical picture of envenoming described as a result of ASP data.

Likewise, analysis of the evolution of envenoming from ASP data has helped guide clinicians in regard to when and by what means they can safely exclude serious envenoming in snakebite cases. This area had been subject to much dogma and smaller less scientifically valid studies prior to the publication of this data and thus ASP has unquestionably changed clinical practice.

To date ASP has provided high quality data on:

  * Brown Snake envenoming clinical picture and AV dosing
  * Tiger snake envenoming clinical picture and AV dosing
  * Rough-scale snake clinical picture and nature and type of AV dosing
  * Nature and frequency of adverse reactions to AV
  * When serious envenoming can be excluded

In the near future data is expected on:

  * Death adder envenoming clinical picture and AV dosing
  * The results of a randomised controlled trial of Fresh frozen plasma versus standard care within 4 hours of AV administration in cases of venom induced consumption coagulopathy

A controlled trial is due to commence early 2013 comparing the efficacy of different AV doses in red bellied black snake bites.