Page 54 - JSOM Summer 2020

Antivenom Algorithm:
CENTCOM AOR NOTE:
Yellow background indicates that
a product meets both criteria below:
1) broad-spectrum regional coverage
Follow list of steps outlined in CPG: 2) freeze-dried / field-stable
Universal Approach to Snakebite
Assessment, Diagnosis, and Treatment

Patient Monitor for 24 hours and
with S/Sx of NO discharge according to
envenomation? Step #17

Yes

CENTCOM AOR CENTRAL ASIA
Region?
(except Central Asia) ONLY

NO Snake ID known?

YES

Confirmed
Syndrome? NO Gloydius halys or other Gloydius
species? (rare)

YES
NEUROTOXIC HEMOTOXIC CYTOTOXIC
1st line = SIOBP-G
Gloydius halys or related Gloydius
species only!
1st line = POLYSERP-M Initial dose = 2 vials,
COMPLETE REGIONAL COVERAGE additional 2 vials as needed
YES POLYSERP-M
available?
Initial dose = 6 vials,
additional 2 vials as needed
NO

MIDDLE EAST /
Region? ARABIAN PENINSULA
CENTRAL ASIA

NAVPC-P YES
available?
RAZI-P
available?
2nd line = NAVPC-P
Moderate coverage for
NEURO / HEMO / CYTO syndromes
YES
NO NO Initial dose varies by syndrome, see below

2nd line = NAVPC-P
2nd line = RAZI-P 2nd line = NAVPC-P
Contact snakebite Contact snakebite Initial dose hemotoxic and/or
Initial dose = 10 vials, Initial dose neurotoxic = 10 vials, cytotoxic = 10 vials,
additional 2 vials as needed expert for consult expert for consult additional 5 vials as needed
additional 5 vials as needed

52 | JSOM Volume 20, Edition 2 / Summer 2020