Page 52 - JSOM Summer 2020

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

Patient with S/Sx of NO
envenomation?
Monitor for 24 hours and
YES discharge according to
NO ANTIVENOM for venom in eyes. Step #17
Antivenom used for bites, not for ocular exposure. Venom ophthalmia?
YES
Irrigate extensively and treat like a chemical (spitting cobras)
exposure. See Venom Ophthalmia section in CPG.
NO

Sub-Saharan Africa Region? North Africa

Syndrome? Syndrome?

NEUROTOXIC HEMOTOXIC CYTOTOXIC NEUROTOXIC HEMOTOXIC CYTOTOXIC

1st line = POLYSERP-P POLYSERP-P POLYSERP-M 1st line = POLYSERP-M
COMPLETE REGIONAL YES YES COMPLETE REGIONAL
COVERAGE ALL SYNDROMES available? available? COVERAGE ALL SYNDROMES
Initial dose = 6 vials IV/IO push, Initial dose = 6 vials IV/IO push,
additional 2 vials as needed additional 2 vials as needed
NO
NO

Syndrome? Syndrome?

NEUROTOXIC HEMOTOXIC CYTOTOXIC NEUROTOXIC HEMOTOXIC CYTOTOXIC

2nd line = NAVPC-P 2nd line = NAVPC-P
2nd line = SAIMR-P 2nd line = SAIMR-P

Initial dose = 10 vials, Initial dose = 10 vials, Initial dose = 10 vials, Initial dose = 5 vials, additional 5
additional 5 vials as needed vials as needed
additional 5 vials as needed additional 5 vials as needed
Boomslang
bite? (rare) Treatment failure? Treatment failure
YES NO
3rd line = POLYSERP-P
2nd line = SAIMR-B Covers some North African species but is
COVERS BOOMSLANG ONLY designed for sub-Saharan Region
Contact snakebite
Initial dose = 2 vials, expert for consult Initial dose = 6 vials,
additional 1 vial as needed additional 2 vials as needed

50 | JSOM Volume 20, Edition 2 / Summer 2020