❓ A WA parliamentary question regarding antivenom stocks, guidelines, and patient data related to snake, spider, and sea animal bites in WA Country Health Service (WACHS) and Silver Chain nursing posts. The response provides information on stock levels, clinical guidelines, telehealth capabilities, and patient presentation data, but acknowledges limitations in data collection from Silver Chain and definitive mortality identification.
AnsweredQoN 1730Legislative Council
Asked
1 November 2018
Member
Portfolio
Deputy Premier; Minister for Health; Mental Health
QuestionView source ↗
I refer to the WA Country Health Service (WACHS) and the stocks of antivenin held for snake, spider and sea animal bites, and I ask: (a) for each WACHS site please list the current stock of antivenin; (b) for each WACHS site please list the recommended stocking quantity of antivenin as established by the WA Therapeutic Advisory Group; (c) for each contracted Silver Chain nursing post please list the current stock and recommended stock of antivenin; (d) what is the WACHS clinical guidance for a patient presenting with a snake, spider or sea animal bite where envenomation is suspected whether or not the patient is displaying symptoms; (e) does the Emergency Telehealth Service have capability for direct connection with and support from the WA Toxicology Service; (f) for each WACHS site and Silver Chain nursing post please provide the number of patients presenting for the last three calendar years with a suspected snake, spider or sea animal bite and the applicable ATS on presentation; and (g) how many of those patients identified in (f) died following the presentation and in connection with the bite?
AnswerView source ↗
Answered
4 December 2018
Responded by
Parliamentary Secretary representing the Deputy Premier; Minister for Health; Mental Health
Response time
10 days
I am advised that:
(a)-(b) All WA regional hospitals stock the recommended types and level of antivenom. Please see tabled paper no. for the full list of available stock. The recommended stock level is included in brackets.
(c) Anti-venom can only be administered by trained staff due to clinical safety issues, and at sites which have access to emergency telehealth so staff can connect to Toxicology specialists. Lancelin and Shark Bay are the only Silverchain nursing post sites with Emergency Telehealth Service (ETS).
Lancelin Remote Nursing Post currently has two vials of anti-venom in stock, which will be restocked as required. Shark Bay Nursing Post currently has no stocks of anti-venom, however stock is expected within 4-6 weeks.
(d) The WA Country Health Service (WACHS) has endorsed snake bite envenoming guidelines which are being reviewed in line with the increased availability of antivenoms. Treatment for marine stings (including sea snakes) and venomous spider bites are through a clinical assessment by the treating clinician on site based on presenting symptoms, with support from ETS where appropriate.
(e) Yes. The ETS has capability for direct connection with and support from the WA Toxicology Service.
(f) Please see tabled paper no. for the number of ED presentations admitted at WACHS sites for the last three calendar years with a suspected snake, spider or sea animal bite. The Department of Health (DOH) does not routinely collect information from Silver Chain nursing posts with regard to snake, spider or sea animal bites, and is therefore unable to provide an answer in this regard.
(g) It is not possible to definitively identify those who died in the ED at regional hospitals as a result of venomous snake, spider or sea animal bite injuries, as the methodology for responding to (f) applied only to patients who went on to be admitted at WACHS sites. As per the answer to (f), the DOH is unable to answer this question in relation to Silver Chain nursing posts.
(a)-(b) All WA regional hospitals stock the recommended types and level of antivenom. Please see tabled paper no. for the full list of available stock. The recommended stock level is included in brackets.
(c) Anti-venom can only be administered by trained staff due to clinical safety issues, and at sites which have access to emergency telehealth so staff can connect to Toxicology specialists. Lancelin and Shark Bay are the only Silverchain nursing post sites with Emergency Telehealth Service (ETS).
Lancelin Remote Nursing Post currently has two vials of anti-venom in stock, which will be restocked as required. Shark Bay Nursing Post currently has no stocks of anti-venom, however stock is expected within 4-6 weeks.
(d) The WA Country Health Service (WACHS) has endorsed snake bite envenoming guidelines which are being reviewed in line with the increased availability of antivenoms. Treatment for marine stings (including sea snakes) and venomous spider bites are through a clinical assessment by the treating clinician on site based on presenting symptoms, with support from ETS where appropriate.
(e) Yes. The ETS has capability for direct connection with and support from the WA Toxicology Service.
(f) Please see tabled paper no. for the number of ED presentations admitted at WACHS sites for the last three calendar years with a suspected snake, spider or sea animal bite. The Department of Health (DOH) does not routinely collect information from Silver Chain nursing posts with regard to snake, spider or sea animal bites, and is therefore unable to provide an answer in this regard.
(g) It is not possible to definitively identify those who died in the ED at regional hospitals as a result of venomous snake, spider or sea animal bite injuries, as the methodology for responding to (f) applied only to patients who went on to be admitted at WACHS sites. As per the answer to (f), the DOH is unable to answer this question in relation to Silver Chain nursing posts.
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