Antivenom: Polyvalent

Dose

1 vial IV administered over 15 min following a 1:10 dilution with sodium chloride 0.9%. Dilution can be 1:5 in young children or patients on fluid restriction.

Stocking recommendations

Rationale

Polyvalent antivenom is the preferred first line option for the management of envenomation due to black snakes, death adder and taipan.  These snakes account for a small number of severe envenomations in most parts of Australia and holding separate monovalent antivenoms for these species is impractical. In smaller centres where snake envenomation is uncommon, stocking a single vial of polyvalent to treat any snake envenomation is the most logical approach.

Precautions

• Hypersensitivity reactions may occur. Antivenom should be administered in a critical care area in anticipation of potential anaphylaxis.
• Premedication with steroids/adrenaline is not recommended.
• If a hypersensitivity reaction occurs, pause the infusion and treat along standard lines. Recommence the infusion once the reaction settles at a slower rate.
• If the hypersensitivity reaction is severe, discuss the case with a clinical toxicologist.

Serum sickness may occur 4 to 14 days following the administration of antivenom. Symptoms include fever, rash, joint and muscle pain, headache, nausea and vomiting.  Patients should be informed of the symptoms and present to their local doctor should they occur.

Disclaimer

Fact sheet developed by Queensland Poisons Information Centre.

This fact sheet is about the use of these antidotes in Australia, and may not apply to other countries. Children’s Health Queensland Hospital and Health Service cannot be held responsible for the accuracy of information, omissions of information, or any actions that may be taken as a consequence of reading this fact sheet.