CSL Antivenom Handbook

Australian Snakes and Snakebite

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Suggested Laboratory Tests for Snakebite Patients in Country Hospitals

Snake venom detection (CSL Kit) on bite site (or urine, only if there is systemic envenoming).

• Coagulation studies. Whole blood clotting time (5-10mL venous blood in a glass test tube and measure time to clot; >12min suspicious of coagulopathy; >20min and no clot very suspicious of severe coagulopathy). If possible, run a normal control using blood from a staff volunteer (ensure that they are not on anticoagulant drugs). Also take blood for laboratory tests performed at the regional hospital laboratories and send off as soon as possible (eg prothrombin time/INR and APTT and if these are prolonged do fibrinogen, fibrin(ogen) degradation products and TCT), complete blood picture (platelet count), plasma/serum electrolytes and renal function (especially K+, creatinine and urea) and CK.

• Urine (ward test=dipstix looking for blood=?myoglobin or ? true haematuria - microscopy required to look for red cells).

All tests should be performed on first presentation and at intervals thereafter, the frequency depending on the results and the patient's condition.