The Dec MJA edition has a clinical update on snake bite in Australia. It is the most evidence based update so far.
Take home messages:
1. Pressure immobilisation bandage still advised. Probably of no use if bite greater than 4 hrs old.
2. Whole blood clotting test using glass vial no longer recommended. IsTAT INR definitely not recommended to assess snake bite coagulopathy
3. Retrieval to hospital that can do formal lab tests is recommended for any suspected snake bite
4. Admission to ED, 1 hr 6 hr and 12 hr labs are advised
5. If antivenin needed, 1 vial is recommended only now. polyvalent 1 vial should cover all suspected envenomations
6. FFP has been shown to improve coagulopathy but not outcomes like discharge times.