PAPUAN TAIPAN (Oxyuranus scutellatus canni) ENVENOMATION IN RURAL PAPUA NEW GUINEA

Nine cases of serious envenomation following bites by Papuan taipans Oxyuranus scutellatus canni are presented. Eight cases were fatal with contributing factors such as delayed presentation with advanced symptoms, incorrect antivenom administration, failure to recognise key indications of envenoming, lack of antivenom, and delayed administration of correct antivenom. The survival of a single patient was greatly assisted by prompt recognition of coagulopathy as a symptom of envenoming, followed by administration of appropriate antivenom and careful patient monitoring using available techniques such as the 20WBCT protocol. A consistent approach to management incorporating strategies such as early recognition of envenomation, prompt pressure immobilisation, precise ongoing clinical assessment and early treatment with appropriate antivenom may improve the prognosis of envenomed patients.