HOW EMILIA SURVIVED AUSTRALIA’S DEADLIEST SNAKE ATTACK
A Perth family’s holiday in WA’s north turned into a nightmare when their little girl was bitten by a deadly snake. Her survival depended on quick action and a big medical team effort.
RUNNING slightly ahead of her parents on the way to the beach was all it took for Perth girl Emilia Barnard to be caught in the middle of a remote medical emergency that nearly claimed her life.
Looking at her now, Emilia is like any normal four-yearold girl — she loves dancing, horses, unicorns, kindy, jumping on the trampoline and playing with her dog, Harry.
But only a month ago, Emilia was in the fight of her short life, bitten twice by a western brown snake — one of the world’s deadliest which can easily kill adults many times her tiny size — on her family’s holiday to idyllic Coral Bay, 1100km north of Perth.
To complicate matters, Emilia and her parents faced a prolonged wait for antivenom to arrive as the nursing post did not have any. The Royal Flying Doctor Service, on its way from Port Hedland to evacuate Emilia, arrived with antivenom after about 31⁄2 hours.
At one point, Emilia stopped breathing for up to two minutes and it took a massive team effort involving nearly a dozen medical professionals and volunteers, including a doctor and two nurses on video link screen from Perth, to save her life.
Emilia’s brush with death hasn’t left any sign of lasting trauma, but her eternally grateful parents, David and Kari, are still processing how close they came to losing their only child.
It was WA Day — the June 4 public holiday — and the Mt Hawthorn family had just started their second day of a planned week-long holiday at a friend’s beachfront house in Coral Bay.
Emilia was eager to get to the beach, so much so that her mother had to chase after her to ensure she didn’t head straight into the water.
Within seconds, Emilia screamed at the top of the stairs leading to the beach.
Ms Barnard right away spotted what had caused her daughter’s pained reaction — a brown snake, disappearing down a hole and similar in colour to the limestone steps.
She yelled out to her husband it was a snake, and after prying Emilia’s feet apart they could see bite marks on Emilia’s right foot.
The panicked parents quickly bundled up their only child and, guided by directions from their friends, sprinted to the local nursing post. They arrived at the single nursing post within 10 minutes, fortuitously at a time when registered nurses Caroline Cordy-Hedge and Jan Saxton were doing a handover.
It was the only hour in the week when both nurses were together. And as it was a public holiday, if the Barnards had arrived a little later the nursing post would have been closed and precious minutes would have been wasted calling the nurse in.
“I didn’t have a lot going through my mind other than trying to work out how serious the situation was. Part of me was thinking it’s probably not poisonous, but when we got to the nursing post I said that and they were like, ‘it’s Australia, they’re all poisonous’,” Ms Barnard, a digital media and IT executive, said.
Ms Cordy-Hedge immediately started applying pressure bandaging to Emilia’s right leg and then splinted both legs together in a bid to stop the venom spreading through her small body, while her colleague urgently dialled the 24/7 Emergency Telehealth Service (ETS) to get expert help from Perth on the video link screen.
By the time doctor Peter Leman was connected, the emergency became even more life-and-death as Emilia had collapsed soon after complaining of a sore head and stomach and stopped breathing on the gurney, forcing Ms CordyHedge to ventilate her for about two minutes before the little girl came to and started breathing on her own again.
“She suddenly let out a scream, ‘my head, my head’, at which stage she collapsed and probably within 30 seconds had stopped breathing,” Ms Cordy-Hedge said.
During this time, the nurses sent the parents out of the room, tasking Ms Barnard with calling triple zero to get help from the town’s volunteer ambulance officers.
In the audio of Ms Barnard’s frantic triple zero call, she can be heard asking the nurses “is she breathing” to which they say no. Mid-way through the call, Emilia regains consciousness.
After about 20 minutes, Emilia started to stabilise but her parents knew they were in for a long wait for the RFDS.
Imperative until the antivenom arrived was keeping Emilia incredibly still to stop the venom spreading.
Under guidance from Dr Leman, the nurses administered the correct weight-ratio dosage of life-saving medicine to help keep Emilia breathing and stable as well as inserting intravenous saline drips into each of the girl’s arms.
Both Emilia’s parents admit they dealt with the shock in different ways — Ms Barnard said she went into “auto-pilot” following instructions from the nurses and doing her best to calm and still her daughter, while her husband felt a heavy sense of helplessness and was battling with thoughts of a worst-case scenario.
Realising the RFDS plane could only carry one parent, Mr Barnard made the tough call to book a flight from Exmouth to Perth, due to leave before the RFDS arrived with the antivenom, to ensure he could meet up with his wife and daughter at Princess Margaret Hospital as soon as possible.
“I didn’t know if I was going to see her again. It was very stressful,” Mr Barnard, a software consultant, said. Of the moment the RFDS doctor and nurse arrived, Ms Barnard said: “I don’t think I’ve ever been so happy to see people walk in the door.”
Adding chaos to catastrophe, the evacuation of Emilia to the RFDS plane took place in the middle of a massive sandstorm, making for a bumpy ride in the air.
Incredibly, after such an emergency, Emilia only needed to stay at PMH overnight for observation.
“We’re extremely fortunate that Emilia is here with us and we know that. It was a very close call,” Mr Barnard said.
Emilia talks matter-of-factly about the snake with the “dirty teeth” and describes her
ordeal in a way only a fouryear-old can.
“It was on a step, I saw something slither . . . it bited me (sic),” she said. Stretching her arms as wide as possible she said “it hurt this much”.
Physically Emilia’s nearly made a full recovery. Arguably, the mental recovery for her parents will take a bit longer.
They cannot fault the treatment their daughter received from experienced medicos, with their only concern being that the nursing post did not have its own antivenom. They were only told that Coral Bay nursing post used to stock antivenom, but not anymore, but were reassured a snake bite victim could wait for antivenom if quick compression bandaging had been done.
But Emilia and her parents have a simple message for the doctors, nurses and volunteers who came to their rescue — thank you.
“It was a well-oiled machine . . . we’re really appreciative of all the help we got on the day,” Mr Barnard said.
The Barnards want other people to learn from their ordeal — by being prepared, carrying a first aid kit, doing a first aid course and remembering to stay calm. “The message . . . is not to be complacent, particularly with children. A lot of us are camping and experiencing this country of ours, but you need to have that sort of gear with you,” Mr Barnard said. Dr Leman, an emergency specialist of 20 years, admits becoming emotional and experiencing a “powerful sense of relief” when the RFDS arrived on the scene. He said the risk of further absorption of the venom remained until the antivenom could be administered. Dr Leman said Emilia was “extremely lucky to be alive”. He said while it was a team effort — with the telehealth service able to rally the RFDS into action and get expert advice from the Poisons Information Service — he was full of praise for the nurses, who made the biggest difference in providing life support and quick, effective first aid. “You want to reach through the TV screen, put your hands in there and help out,” Dr Leman said. “In actual fact I didn’t need to be there because Caroline and Jan did all the work . . . they were brilliant.”
Ms Cordy-Hedge, a nurse of 30 years, said the ETS was an incredible resource in rural and remote WA.
A WA Country Health Service spokeswoman said antivenoms for WA’s three most common snakes — brown, black and tiger — were widely distributed across the State — 46 sites were in the country, including small hospitals. Those included Exmouth and Carnarvon, relatively close to Coral Bay.
Antivenom distribution was not as widespread in the past because standard snake bite management “required pathology reporting before the relevant antivenom could be administered”.
But research published last year has removed the need for venom detection beforehand. The spokeswoman said WACHS distributed antivenom above the recommended level, but is aware of a recent review and waiting to implement recommendations.
From January to June this year, 151 people have been admitted to hospitals in WA for snake bites. Last year, the total was 295 compared with 232 in 2012.
Ms Cordy-Hedge estimated the Coral Bay nursing post dealt with at least five suspected snake bites a year, but most didn’t involve actual injection of venom. Emilia’s case was by far the worst she’d seen.
“The stars all lined up for Emilia,” she said.
Survivor: Left, Emilia Barnard plays with her favourite toys after making a full recovery from the snake bite. Above, Emilia is transferred by RFDS from Coral Bay to Perth. Right, In PMH soon after her ordeal. Below, Mum and dad, Kari and David Barnard, with Emilia. Main picture: Ross Swanborough