What is Envenomation?

Venom is a poisonous secretion of an animal, such as a snake, spider, or jellyfish. It is usually transmitted into the victim by a bite or sting. There are many venomous creatures in Australia, both on land and in the sea. Envenomation is the entry of venom into a person’s body, and it may cause localised or systemic poisoning. While envenomation does not cause many deaths in Australia (approximately 2 to 3 each year), it may cause serious illness requiring admission to the intensive care unit.

What are the signs and symptoms of Envenomation?

• Local tissue damage
• Pain at site of bite/ sting
• Low blood pressure (hypotension)
• Headache
• Blurred vision
• Nausea /vomiting
• Abdominal pain
• Lymphadenopathy (abnormally large lymph nodes, or swollen glands)
• Coagulation problems (abnormal clotting of the blood)
• Rhabdomyolysis - Rhabdomyolysis is the breakdown of muscle cells resulting in the release of the muscle cells (myoglobin) into the bloodstream. Some of these are harmful/ toxic to the kidney and may lead to acute renal failure.
• Muscle weakness/ Muscular paralysis
• Sudden collapse and death

What is anti venom?

Antivenom (or antivenin) is a medication used in the treatment of poisonous bites or stings. It works by neutralising the poisonous venom that has been transmitted in to the victim. It is injected into either a muscle or vein of a patient.

What happens in the Intensive Care Unit?

• Monitoring of the heart rate, blood pressure, oxygen saturation and temperature. This will be seen on a bedside monitor.
• An arterial line may be inserted to monitor blood pressure and to take blood samples.
• Medication and intravenous fluids may be given via a central venous catheter including sedatives (to assist in sleep), analgesics (pain killers) and antibiotics (for infections). These medications will be given via infusion pumps.
• Oxygen may be delivered via a face mask, and mechanical ventilation via an endotracheal tube or tracheostomy may be required to assist with breathing. The ventilated patient will require suctioning to remove secretions from the lungs and airways.
• Nutrition may be given via a nasogastric tube. This is a tube that is placed in the nose and goes down the throat into the stomach. Fluid can also be removed from the stomach via the nasogastric tube.
• Insertion of an indwelling catheter to drain and measure urine output.
• Chest x rays and other tests such as blood tests.
• Dialysis may be required to support the kidneys if they are failing.
• Sequential compression devices may be put on the legs to prevent the formation of blood clots.
• An air mattress may be used to prevent pressure areas developing.

How long will the patient remain in ICU?

A patient’s stay in ICU may only be for a few days, but could be longer if there are complications. Please ask the ICU nurse or doctor if you have any questions.

Internet Links

Australian Rescusitation Council

The information contained on this page is general in nature and therefore cannot reflect individual patient variation. In addition it reflects Australian intensive care practice which may differ from other countries. It is meant as a back up to specific information which will be discussed with you by the Doctors and Nurses caring for your loved one. ICCMU attests to the accuracy of the information contained here BUT takes no responsibility for how it may apply to an individual patient. Please refer to the full disclaimer.

Envenomation Version 1
Author Kathleen Ryan CNC ICCMU
First published August 2008