Safe and effective broad-spectrum, field-stable antivenoms are available for all three syndromes of snake envenomation in Southeast Asia and several other areas within this AOR. Snakebite treatment in INDOPACOM as a whole is more complex than AFRICOM or CENTCOM due to the lack of a truly pan-Asian polyvalent product. Treatment in many places does not require identification of the species responsible, but products are syndrome specific and there is no single product for all 3 syndromes. Snakebite treatment at the point of injury is recommended for areas within the INDOPACOM AOR where field-stable antivenoms are available. This section provides specifics about antivenoms use in this region.

Adverse Reaction Management

Sudden Collapse Syndrome Treatment Protocol

Patient presents within 30 minutes of the bite with rapid onset shock ± angioedema, altered mental status, systemic bleeding, and diarrhea.1

  1. Stabilize with IM or IV epinephrine and fluids as per anaphylaxis protocols
  2. Intubate for airway edema not rapidly responsive to epinephrine
  3. Follow epinephrine immediately with a high dose of the appropriate regional antivenom given by rapid IV or IO push during the resuscitation
  4. Maintain blood pressure with IV or IO fluids and epinephrine until antivenom has taken effect to reverse the hypotension.

See Sudden Collapse Syndrome section for more information.

 

CONTACT

For emergency consultations, call the ADVISOR telemedicine hotline (866-972-9966) and select toxicology from the phone menu.

For additional information about snake bite management or this CPG, email jordan@snakebitefoundation.org or call 415-218-2211.