WCH Clinical Toxinology Resources

laboratory_tests_full

Laboratory tests

A regional or teaching hospital
If full laboratory facilities are available, use them! The following should be performed, labelled urgent:

Extended coagulation studies; prothrombin time/international normalised ratio (PT/INR), activated partial thromboplastin time (apt), fibrinogen level, cross linked or d-dimer degradation products of fibrin/ fibrinogen degradation products (XDP/FDP).
Complete blood picture; especially platelet and absolute lymphocyte counts.
Electrolytes, urea, creatinine.
Creatinine phosphokinase
Where appropriate, arterial blood gas estimation.
Examination of peripheral blood smear for evidence of microangiopathic hemolysis, suggestive of disseminated intravascular coagulation.
Only in Australia; snake venom detection on the bite site swab (see “Venom detection” in chapter on Australian snakebite).

In a large Australian city or country regional or base hospital, the following tests are required:

Venom detection using the SVDK.
Extended coagulation studies (PT/INR, aPTT, fibrinogen, FDP/XDP).
CBP/FBP/CBE (especially platelet count and absolute lymphocyte count).
Electrolytes and renal function.
CK

If initial tests are normal, repeat 2-3 hours and 5-6 hours later, or earlier if symptoms of envenoming develop. If initial tests are abnormal and antivenom therapy is commenced, re-test at 3 hours after completion of antivenom, to decide if more antivenom is needed (if there is a coagulopathy present).

Return to Diagnosis Overview page

Go to Differential Diagnosis page

Return to Snakes Overview main page

Go to Snakes Treatment Overview

IMPORTANT INFORMATION FOR ALL SITE USERS : The principle aim of this site is to provide information useful to improving outcomes for humans suffering from envenoming or poisoning by animals, plants or mushrooms. We make a reasonable attempt to verify accuracy of information listed on this site. However, we cannot access every published paper of potential relevance, either because they are not available to us or are in a language we cannot translate internally. Equally, we cannot list knowledge which is not yet reported or known. It should not be assumed that humankind currently knows all there is to know about any species, even for common species. Further, we cannot control how users will interpret the information provided on this site. We therefore do not accept legal responsibility for use of the information provided and we require that all users use information from this site at their own risk.
The following should also be noted when reading information contained within the databases on this website: italics for scientific nomenclature cannot be displayed, and superscripting and subscripting is absent in some instances.
Photos downloaded from Wikimedia Commons or other website are licensed for use under the Creative Commons Attribution-Share Alike 2.0 Generic license (CC BY-SA 2.0), 2.5 Generic license (CC BY-SA 2.5) or 3.0 Unported license (CC BY-SA 3.0), or the Attribution-NonCommerical-ShareAlike 3.0 Unported license (CC BY-NC-SA 3.0), or the Attribution-Share Alike 4.0 International license (CC BY-SA 4.0), or the GNU General Public License (GPL3.0), or in the Public Domain (PD), as shown in the caption to the image displayed on www.toxinology.com.