Abstract:
Snake bites carry a high rate of morbidity and mortality as a result of the local and multi systemic
complications. There is an estimated 40,000 snake bites every year in Sri Lanka. Coagulopathy is
one of the main complications caused by the venom of Viperidae. The toxic effect of the venom
activates enzymatic pathways which results in crisis of homeostasis. The current practice of
detection of coagulopathy is by the 20 minutes whole blood clotting time (20 WBCT).
Coagulopathy also leads to the alterations of Prothrombin Time (PT), INR, Activated Partial
Thromboplastin Time (APTT) and Thrombin Time (TT). A discrepancy between 20 WBCT and
the coagulation profile has been observed in some instances. A recent study concluded that
WBCT was not a good test to identify coagulopathy in Russell’s viper envenomation.
