Coagulopathy from tiger snake envenoming and its treatment

[Extract] Sir, We would like to make some comments on two articles recently published on tiger snake bite and the resultant coagulopathy that occurs with envenoming. Both articles discuss important issues relating to the coagulopathy associated with Australasian elapid envenoming. They correctly make the distinction between snake venominduced activation of the coagulation cascade (VIACC) and disseminated intravascular coagulation (DIC). VIACC is often loosely referred to as defibrination, but is more accurately termed fibrinogen depletion. The article on eastern tiger snake envenoming provides important new information by reporting serial measurements of prothrombin cleavage fragments which has not been previously investigated. It demonstrates that the presence of F1 + 2 levels are possibly highly sensitive tests for envenoming.

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