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Biomedical subjects

S K Sutherland

Publications and source records attributed to S K Sutherland.

108 records · Page 6Linked to original sources
PubMedDate not supplied

Funnel-web spider (Atrax robustus) antivenom in the treatment of human envenomation.

Envenomation by the Sydney funnel-web spider may lead to serious illness or death. After an antivenom which had been raised in rabbits was proven to reverse the signs of envenomation in animals, a trial was conducted in patients. Nine patients (aged 3-82 years) with severe envenomation by funnel-web spiders received treatment with an antivenom to the venom of Atrax robustus. Concomitant diseases in the victims included rheumatoid arthritis, diabetes mellitus, complete heart block, pyrexia of unknown origin, and carcinoma of the ovary, which were being treated with appropriate drugs. Because of the introduction of the antivenom, the syndrome which previously caused either death or a hazardous illness which required two to three weeks of hospital care now became an illness lasting one to three days. So far there have been no definite adverse reactions to the antivenom. There have been no deaths since the antivenom has been used, and it is hoped that human fatalities as a result of funnel-web spider envenomation will become a thing of the past.

Adolescent↗
PubMedDate not supplied

Deaths from snake bite in Australia, 1981-1991.

OBJECTIVE: To obtain and analyse data relating to snake bite fatalities in Australia. DESIGN: Retrospective analysis of case reports and collation of studies carried out at the Commonwealth Serum Laboratories (CSL). RESULTS: 18 deaths attributed to snake bite were reported to CSL over a 10-year period. Eleven of the victims were males and four of these were bitten after either picking up the snake or playing with it. In most cases, no pathological findings of significance were found at autopsy. Venom was detected in post-mortem samples from nine cases. Brown snakes (genus Pseudonaja) were responsible for 11 deaths; tiger snake (Notechus scutatus) for four, taipan (Oxyuranus scutellatus) two and death adder (Acanthophis australis) one. Death after a brown snake bite was often sudden and unexpected. In three patients bitten by tiger snakes and in one bitten by a brown snake, the presence of cerebral haemorrhage was confirmed at autopsy. CONCLUSIONS: Not all snake bite deaths in Australia are adequately investigated or reported. Under some circumstances death from snake bite is almost inevitable; two infants who received unwitnessed massive envenomations are tragic examples. Had venom absorption from the bitten area been delayed by correct first aid, some of the patients might have survived. The brown snakes (genus Pseudonaja) must now be considered Australia's most dangerous group of snakes because their venom may cause sudden unexpected collapse and death. The increased incidence of intracranial haemorrhage may in some cases be related to the intravenous use of adrenaline. In at least one case, the prompt administration of a clearly needed antivenom might have altered the outcome.

Adolescent↗
PubMedDate not supplied

Snakebite deaths in Australia 1992-1994 and a management update.

Twelve deaths attributed to snakebite were reported in 1992-1994. Eight of the victims were males, and brown snakes (genus Pseudonaja) were involved in six of the deaths. Deaths caused by brown snakes were often sudden and unexpected, and autopsy findings were usually unremarkable. In no case was prompt effective first aid applied. The importance of appropriate first aid is emphasised and an update on management presented.

Adult↗
PubMedDate not supplied

Antivenom use in Australia. Premedication, adverse reactions and the use of venom detection kits.

OBJECTIVES: To analyse reports of antivenom use and sequelae in Australia from July 1 1989 to June 30 1990. The value of snake venom detection kits (VDKs) was also analysed. METHODS: Information was obtained from antivenom usage reports returned to the Commonwealth Serum Laboratories and from personal letters sent to those reporting doctors. Information on VDKs was obtained from antivenom usage reports or from questionnaires packaged with VDKs. RESULTS: Reported antivenoms used were: red-back spider, 258 cases; funnel-web spider, 3 cases; stonefish, 26 cases; box jellyfish, 6 cases; snake, 91 cases. Immediate reactions followed administration of red-back spider antivenom in only two patients and snake antivenoms in four patients. Delayed reactions (serum sickness) followed use of red-back spider antivenom in three patients, stonefish antivenom in two, and snake antivenoms in three. No reaction was life-threatening. Premedication was used in the majority of red-back spider bites and in 66 of 86 snake bites. Oral corticosteroids were given prophylactically after some uses of snake antivenom to prevent serum sickness. VDKs were used in 181 cases of snake bite and were reported as being useful in selecting appropriate snake antivenom in 31% of cases of antivenom use. (Only 10 of these 181 were also reported on the antivenom usage report.) Appropriate first aid was given in 61% of cases. There were 50% fewer snake bites reported than 10 years ago. CONCLUSIONS: Antivenoms in Australia are well tolerated with few immediate or delayed reactions. The use of premedication and prophylactic oral corticosteroids for four to five days after antivenom administration may be responsible for this low reaction rate. VDK results help select the appropriate antivenom; however, in some cases positive results were obtained from urine samples from patients with no symptoms of envenomation.

Adolescent↗