investigations

Last reviewed 07/2021

  • FBC - neutrophil leucocytosis is common; anaemia may result from extravasation into the bitten limb and haemolysis; thrombocytopenia
  • clotting screen - mild coagulopathymay occur (prolonged prothrombin time and activated partial thromboplastin time, hypofibrinogenaemia, and raised fibrin degradation products or D-dimer) Consumption coagulopathy is uncommon
  • biochemistry - raised serum creatine kinase, transaminases, urea, and creatinine may occur; bicarbonate may be reduced
  • ECG - possible features include include tachyarrhythmias, bradyarrhythmias, atrial fibrillation, flattening or inversion of T waves, ST elevation or depression, second degree heart block. Myocardial infarction may occasionally occur following an adder bite.

Reference:

  1. Warrell DA. Treatment of bites by adders and exotic venomous snakes. BMJ 2005; 331:1244-47