The Australian Snakebite Project (ASP) is a multicentre project which set out to collect prospective data on presumed and definite snakebite victims regardless of whether envenomed or not. Data from ASP has been recorded from greater than 150 hospitals within Australia. As a result the evidence basis for management decisions in snakebite has increased immensely.
As well as demographic and clinical information, venom specific enzyme immunoassays were developed for a number of common snake groups. This allowed individual envenomed cases to be definitively identified as envenomed by a specific snake group by virtue of an assay showing a serum concentration consistent with envenoming. In cases where blood sampling was done before and after administration of antivenom (AV), this provided information on how useful AV was in removing the toxins by virtue of whether venom was still present post AV and how much AV had been used. Additionally other less well described groups of snakes such as rough-scaled and broad headed snakes, have had their clinical picture of envenoming described as a result of ASP data.
Likewise, analysis of the evolution of envenoming from ASP data has helped guide clinicians in regard to when and by what means they can safely exclude serious envenoming in snakebite cases. This area had been subject of much dogma and smaller less scientifically valid studies prior to the publication of this data and thus ASP has unquestionably changed clinical practice.

To date ASP has provided high quality data on :
  • The clinical picture and AV dosing for all major Australian snakes1-9
  • Nature and frequency of adverse reactions to AV10, 11
  • When serious envenoming can be excluded12
  • The use of FFP in snake bite coagulopathy13
A controlled trial is due to commence early 2014 comparing the efficacy of different AV doses in red bellied black snake bites
Protocols and information for the Australian snakebite project can be downloaded

References

1. Kulawickrama S, O'Leary MA, Hodgson WC, Brown SG, Jacoby T, Davern K, Isbister GK. Development of a sensitive enzyme immunoassay for measuring taipan venom in serum. Toxicon. 2010; 55(8): 1510-8.
2. Gan M, O'Leary MA, Brown SG, Jacoby T, Spain D, Tankel A, Gavaghan C, Garrett P, Isbister GK. Envenoming by the rough-scaled snake (Tropidechis carinatus): a series of confirmed cases. Med J Aust. 2009; 191(3): 183-6.
3. Churchman A, O'Leary MA, Buckley NA, Page CB, Tankel A, Gavaghan C, Holdgate A, Brown SG, Isbister GK. Clinical effects of red-bellied black snake (Pseudechis porphyriacus) envenoming and correlation with venom concentrations: Australian Snakebite Project (ASP-11). Med J Aust. 2010; 193(11-12): 696-700.
4. Isbister GK, O'Leary MA, Elliott M, Brown SG. Tiger snake (Notechis spp) envenoming: Australian Snakebite Project (ASP-13). Med J Aust. 2012; 197(3): 173-7.
5. Isbister GK, White J, Currie BJ, O'Leary MA, Brown SG. Clinical effects and treatment of envenoming by Hoplocephalus spp. snakes in Australia: Australian Snakebite Project (ASP-12). Toxicon. 2011; 58(8): 634-40.
6. Currie BJ. Snakebite in tropical Australia: a prospective study in the "Top End" of the Northern Territory. Medical Journal of Australia. 2004; 181(11-12): 693-7.
7. Johnston CI, O'Leary MA, Brown SG, Currie BJ, Halkidis L, Whitaker R, Close B, Isbister GK. Death Adder Envenoming Causes Neurotoxicity Not Reversed by Antivenom - Australian Snakebite Project (ASP-16). PLoS Negl Trop Dis. 2012; 6(9): e1841.
8. Allen GE, Brown SG, Buckley NA, O'Leary MA, Page CB, Currie BJ, White J, Isbister GK. Clinical Effects and Antivenom Dosing in Brown Snake (Pseudonaja spp.) Envenoming - Australian Snakebite Project (ASP-14). PLoS One. 2012; 7(12): e53188.
9. Johnston CI, Brown SG, O'Leary MA, Currie BJ, Greenberg R, Taylor M, Barnes C, White J, Isbister GK. Mulga snake (Pseudechis australis) envenoming: a spectrum of myotoxicity, anticoagulant coagulopathy, haemolysis and the role of early antivenom therapy - Australian Snakebite Project (ASP-19). Clin Toxicol (Phila). 2013; 51(5): 417-24.
10. Isbister GK, Brown SG, MacDonald E, White J, Currie BJ. Current use of Australian snake antivenoms and frequency of immediate-type hypersensitivity reactions and anaphylaxis. Med J Aust. 2008; 188(8): 473-6.
11. Isbister GK, Brown SG. Bites in Australian snake handlers--Australian snakebite project (ASP-15). QJM. 2012; 105(11): 1089-95.
12. Ireland G, Brown SG, Buckley NA, Stormer J, Currie BJ, White J, Spain D, Isbister GK. Changes in serial laboratory test results in snakebite patients: when can we safely exclude envenoming? Med J Aust. 2010; 193(5): 285-90.
13. Isbister GK, Buckley NA, Page CB, Scorgie FE, Lincz LF, Seldon M, Brown SG. A randomized controlled trial of fresh frozen plasma for treating venom-induced consumption coagulopathy in cases of Australian snakebite (ASP-18). J Thromb Haemost. 2013; 11(7): 1310-8.