Fatal cerebral haemorrhage after tiger snake (Notechis scutatus) envenomation

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Abstract
Objective: This case report illustrates the threat to life posed by tiger snake venominduced coagulopathy, the importance of first‐ald, precautions with antivenom administration, the dose of antivenom and the necessity to monitor the coagulation status. Case summary: An 11‐year‐old child was envenomated several times by a tiger snake (Notechis scutatus). Despite administration of three ampoules (9000 units) of tiger snake antivenom, fatal cerebral haemorrhage occurred. Inadequate tirst‐aid had been applied. The bite site was covered with a loose bandage instead of a pressure mmobilisation bandage. In hospital, facilities to monitor coagulation status were unavailable. Conclusions: More public education is required in first‐aid management of snake envenomation. Frequent monitoring of coagulation status Is necessary to optimise antivenom and coagulation factor therapy.

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