| QUOTE |
| For bites by the red bellied black snake and the blue bellied black snake (=spotted black snake), antivenom is often less important, as these bites are rarely life threatening, though they may be distressing for the patient. Certainly, only cases with major systemic envenoming should be considered for antivenom therapy. As paralysis and coagulopathy do not occur, they cannot be used as criteria of envenoming. Myolysis, if present at all, is generally very mild, with peak CK of <2000IU. This does not, by itself, warrant antivenom therapy. If the patient is a young child or elderly or infirm, then antivenom therapy should be considered more actively. Apart from these patients, in ormal healthy adults, antivenom is best reserved for severe envenoming with recurrent vomiting, major abdominal pain or headache, or where there are other significant symptoms or signs. Transient headache, vomiting or abdominal pain are not sufficient to commence antivenom therapy following bites by these snakes. If antivenom is to be used, CSL Tiger Snake Antivenom is effective and is preferred to CSL Black Snake Antivenom for two reasons; it is lower volume, therefore safer, and it is cheaper. One vial will often be sufficient, though occasionally 2 or more vials are needed to resolve all symptoms. |