Posted on 06/27/2022 7:34:49 PM PDT by ConservativeMind
The increased availability of D-Dimer testing—a blood test that checks for, or monitors, blood-clotting problems—may be a vital aid to the early diagnosis of venom-induced consumption coagulopathy (VICC), the most frequent systemic effect of snakebite in Australia, according to research.
"D-dimer values exceeded 2.5 mg/L from three hours after the bite for 95% of patients who developed VICC, and were lower than 2.5 mg/L for 95% of non-envenomed patients up to six hours after the bite," Isbister and colleagues reported.
"Diagnostic performance increased during the first three hours after snakebite; for quantitative D-dimer testing at 2–6 hours, the area under the receiver operating characteristic curve (AUC) was 0.99; with a cut-off of 2.5 mg/L, sensitivity was 97.1% and specificity 99.0% for VICC," they wrote.
"For 36 patients with normal international normalised ratio (INR) and activated partial thromboplastin time (aPTT) values 2–6 hours after snakebite, the AUC was 0.97; with a cut-off of 1.4 mg/L, sensitivity was 94% and specificity 96%.
"In all but one of 84 patients who developed VICC-related acute kidney injury, D-dimer values exceeded 4 mg/L within 24 hours of the bite."
Isbister and colleagues said that "from 2–3 hours after snakebite, changes in D-dimer level clearly distinguished between non-envenomed patients and patients with VICC".
"During the first two hours, the D-dimer concentration was lower than 2.5 mg/L in some patients who subsequently developed VICC, indicating that it should be re-assessed later if the initial value is below this cut-off."
"However, D-dimer testing will not be useful for diagnosing envenoming without VICC; for instance, following bites by black snakes (Pseudechis spp., including red-bellied black snakes) or death adders (Acanthophis spp.). In these cases, non-specific symptoms, such as vomiting and headache, may be the only early indications of envenoming."
(Excerpt) Read more at medicalxpress.com ...
This could save tens of thousands of dollars of treatment, per bite.
Does this work for snakes that produce neurotoxic venom like a coral snake? Fortunately they don’t bite too often.
“The doctor says you’re going to die.”
GMTA
You beat me as soon as I saw the title.
If the area of the body bitten begins to swell and turn the magnificent color of black… it was not “dry”.
The test for a black mamba bite is quicker than that. The doctors come back an hour after the bite and if the person is still alive, it must have been a dry bite.
I had a patient that got bit by a coral snake. He was treating a house for termites and there was a weed blocking him. He reached down to pull it out and drew back his hand with coral snake dangling from the skin fold between his thumb and index finger. He beheaded the snake with wire cutters, so a positive identification was able to be made.
I took over his care in the ICU about 4 hours later. His paralysis was developing but stable. Luckily, the local zoo was one of the biggest producers of antivenin. He made a good recovery.
The snake’s body was in a suction canister at his bedside.
What kind of snake is it?
One way to find out is to pet the snake by scratching it behind the ears.
If it bites you and you die then it is a poisonous snake.
If it bites you and you just have a painful bite then either way it means the snake is upset because it has no ears and resents you for reminding it.
Try a tummy rub instead....
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