Figure (16) Western Brown Snake (
The colour of Brown Snakes is very variable and misleadingfor identification purposes. They may be brown, red brown,grey, very dark brown and may be plain in colour, havespeckling, stripes or bands, or have a dark or black head.Length is variable, but can occasionally reach 2 metres.
Figure (17) Western Brown Snake – black head colourphase
The Ringed Brown Snake is smaller than its cousins, andalthough it can cause envenoming, there is no evidencethat it can cause severe or life threatening envenoming,and unlike all its cousins, the venom lacks a procoagulantand therefore cannot cause a coagulopathy.
Figure (18) Ringed Brown Snake (
)Figure (19) Juvenile Brown Snake
Clinical venom effects
Powerfully toxic venom, with potential to causecoagulopathy, renal failure and paralysis. In practice, thedominant feature of Brown Snake envenoming iscoagulopathy (defibrination type). Paralysis is only veryrarely seen, usually in bites where there has been a longdelay in giving antivenom therapy. Renal failure is amoderately common feature of Brown Snakeenvenoming in adults and is usually an acute tubularnecrosis, which may require a period of haemodialysis.The risk seems increased if the patient has also hadalcohol near the time of the bite. If renal failure ispresent then the coagulopathy is usually of the true DICtype, with thrombocytopenia.The Ringed Brown Snake does not appear to causecoagulopathy or severe envenoming.
The expected pattern if Brown Snake venom is present ispositive in well 2 + well 7 (positive control). It is unclearwhat pattern may result with Ringed Brown Snakevenom.
Preferred antivenom is CSL Brown Snake Antivenom. Thestarting dose for severe Brown Snake envenomation iscurrently being investigated by a national multi-centreprospective trial. The initial dose may range from 2 to 5 vials.In small remote centres, the current recommended initialdose in a life-threatening situation is 2 vials. Organise medicalretrieval as early as possible for the patient to be imme-diately transferred to the closest regional or tertiaryreferral hospital for ongoing management and additionaldoses as required.
PAGE 28NSW HEALTHSnakebite and Spiderbite Clinical Management Guidelines