Venomous snakebites worldwide with a focus on the Australia-Pacific region: current management and controversies.

Snakebites are estimated to cause approximately 100,000 deaths each year worldwide and disproportionately affect rural populations in resource-poor settings. Snake venoms may produce local tissue damage and/or distinct clinical syndromes, including neurotoxicity, coagulopathy, hypotension, rhabdomyolysis, and renal failure. Field management is aimed at delaying systemic absorption of toxins, minimizing local damage and infection, and expediting transport to medical facilities. The use of the pressure-immobilization method remains controversial. The use of antivenom, administered in a timely fashion and in adequate doses, is the mainstay of hospital treatment of significant envenomation. The availability, efficacy, and safety of antivenoms vary throughout the world, with a current crisis in antivenom supplies. Copyright 2004 Sage Publications