title: Fatal cerebral haemorrhage after tiger snake (Notechis scutatus) envenomation.
abstract: OBJECTIVE
  This case report illustrates the threat to life posed by tiger snake venom-induced coagulopathy, the importance of first-aid, precautions with antivenom administration, the dose of antivenom and the necessity to monitor the coagulation status.
  
  
  METHODS
  An 11-year-old child was envenomated several times by a tiger snake (Notechis scutatus). Despite administration of three ampoules (9000 units) of tiger snake antivenom, fatal cerebral haemorrhage occurred. Inadequate first-aid had been applied. The bite site was covered with a loose bandage instead of a pressure-immobilisation bandage. In hospital, facilities to monitor coagulation status were unavailable.
  
  
  CONCLUSIONS
  More public education is required in first-aid management of snake envenomation. Frequent monitoring of coagulation status is necessary to optimise antivenom and coagulation factor therapy.
authors.affiliation: Intensive Care Unit, Royal Children's Hospital, Parkville, Vic.
authors.forename: J
authors.initials: J
authors.lastname: Tibballs
authors.forename: R D
authors.initials: RD
authors.lastname: Henning
authors.forename: S K
authors.initials: SK
authors.lastname: Sutherland
authors.forename: A R
authors.initials: AR
authors.lastname: Kerr
mesh_terms: D001777:Blood Coagulation; D002543:Cerebral Hemorrhage / Q000209:etiology*; D002648:Child; D006801:Humans; D008297:Male; D012909:Snake Bites / Q000097:blood / Q000150:complications* / Q000628:therapy