2013
DOI: 10.1016/j.wem.2013.08.001
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Management of Snakebite and Systemic Envenomation in Rural Ecuador Using the 20-minute Whole Blood Clotting Test

Abstract: Objectives In low-income countries, snakebites are frequently managed in rural areas in health centers with severely constrained resources. Many healthcare providers in these settings have limited access to the numerous and relatively expensive laboratory studies used to diagnose envenomation. The relatively simple and inexpensive 20-minute whole blood clotting test (WBCT) has been recommended by several international organizations for the diagnosis of certain venomous snakebites. This study proposes to confir… Show more

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Cited by 23 publications
(32 citation statements)
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“…In tropical countries, snakebites usually occur in rural areas and patients may be treated in remote health centers without laboratory facilities. 19 Thus, bedside clotting tests may be the only auxiliary tool to confirm snakebite envenomation. This may allow prompt clinical decision-making, prevent any delay in antivenom therapy, when it is available, and costs to transport the patient or blood samples to secondary hospital units.…”
Section: Discussionmentioning
confidence: 99%
“…In tropical countries, snakebites usually occur in rural areas and patients may be treated in remote health centers without laboratory facilities. 19 Thus, bedside clotting tests may be the only auxiliary tool to confirm snakebite envenomation. This may allow prompt clinical decision-making, prevent any delay in antivenom therapy, when it is available, and costs to transport the patient or blood samples to secondary hospital units.…”
Section: Discussionmentioning
confidence: 99%
“…The 20WBCT is commonly used globally in the rural tropics where medical laboratories may be difficult to access, and has certainly been a useful test in a variety of clinical settings (e.g. see Sano-Martins et al, 1994;Gaus et al 2013;Iliyasu et al, 2015). However, the assay has variable sensitivity and specificity and thus can yield false negatives or positives under some clinical circumstances (Isbister et al, 2013;Ratnayake et al, 2017).…”
Section: Discussionmentioning
confidence: 99%
“…International health providers use ‘whole blood clotting’ tests (WBCTs) to identify coagulopathy (due largely to hypofibrinogenemia) in snakebite victims, surgery patients, and others. 11 WBCTs lack objectivity for the purpose of guiding blood component therapy.…”
Section: Discussionmentioning
confidence: 99%