Note: This is the seventh installment in a seven-part series Brian Doyle prepared to help colleagues make the most of an emergency medicine rotation Down Under.
Part VII:
Snakes, spiders, shark bites, manta rays, killer jellyfish!!
A lot is made in the American press about the dangerous animals in Australia. The reality is that the Australians are more fearful of the animals in the USA (killer bears and moose that will stomp you to death!) and gun-toting rednecks. The last recorded death from a snake bite in Tasmania was from a Tiger snake in 1966! You will quickly find that it is safer in Australia (especially Tasmania) when it comes to crime and wild animals. Much of what is written about Australia involves a lot of sensationalism… but heck… sensationalism sells!
There are three species of snakes in Tasmania (tiger, copperhead, and whip snake) and they are all poisonous. Takes the guesswork out of the equation! They are very timid and usually run away unless they are provoked by drunk 25 y/o white males. The species are all elapids… not crotalids like the USA. This means they are primarily neurotoxic rather than tissue toxic. You cannot rely upon local findings and local symptoms to determine envenomation. You must rely upon labs and systemic symptoms. Constriction bands are used to prevent lymphatic flow in the prehospital setting and there are a few other things that you can read about. In almost three years of working in Australia, I have never had to give antivenin. Bites are VERY rare in Tasmania. I have perhaps seen 2 or 3 possible envenomations that turned out to be either dry bites or no bites at all.
Perhaps more dangerous is the “Jack-jumper” ant. They cause anaphylaxis just like our bee stings in the USA and are treated the same. Give adrenalin (epinephrine) and lots of it! I see a case every few months.
The most dangerous activity in Australia is driving your car. Not snakes, spiders, manta rays, killer jellyfish….
Bottom line: Don’t be intimidated!
As I have already mentioned, I have highlighted the differences. The reality is that there are far more similarities! Just practice the best medicine you already know and things will be fine.
And have fun!!! It’s sure the Australians will!!! Brian