Brown Snake Envenomation Workup

Updated: Jun 15, 2018
  • Author: David Cheng, MD; Chief Editor: Joe Alcock, MD, MS  more...
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Workup

Laboratory Studies

Laboratory studies can include the following:

  • Complete blood cell (CBC) count

  • Prothrombin time (PT)/activated partial thromboplastin time (aPTT)/international normalized ratio (INR) - Mild envenomation INR greater than 2; complete defibrination INR greater than 12 [9]

  • Fibrinogen - Severe envenomation associated with afibrinogenemia (<0.3 g/L)

  • Fibrin degradation products

  • D-dimer

  • Electrolytes

  • Blood urea nitrogen (BUN) and creatinine

  • Urinalysis

  • Type and crossmatch for packed red blood cells (PRBCs), fresh frozen plasma (FFP), and platelets

  • CSL commercial snake venom qualitative detection kit

  • Enzyme immunoassays (EIAs) for quantifying venom concentration [10] : A small study of 27 brown snake envenomed patients showed the median venom concentration was 20 ng/mL. The EIA test is able to detect down to concentrations of 3 ng/mL. [11]

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Imaging Studies

Imaging studies may include chest radiography and computed tomography (CT) scan of the head if intracranial hemorrhage is suspected.

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Other Tests

Electrocardiogram (ECG) may be necessary.

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