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Thromboelastometry (ROTEM) and thromboelastography (TEG) in copperhead snakebites: a case series.

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Summary

Copperhead snakebites rarely cause blood clotting problems. Advanced tests like ROTEM and TEG did not reveal any significant coagulopathy in patients with copperhead envenomation.

Keywords:
Agkistrodon contortrixcase seriescoagulationcopperheadthromboelastographythromboelastometry

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Area of Science:

  • Toxicology
  • Hematology

Background:

  • Copperhead snakebites are common in the US, causing local symptoms.
  • Unlike other pit vipers, copperheads are not typically associated with coagulopathy.

Purpose of the Study:

  • To evaluate coagulation parameters in patients with copperhead envenomation.
  • To compare standard coagulation tests with advanced functional tests (ROTEM/TEG).

Main Methods:

  • Retrospective review of patients with copperhead envenomation.
  • Analysis of standard coagulation tests (PT, INR, PTT, platelets, fibrinogen, D-dimer).
  • Comparison with advanced functional coagulation tests (ROTEM/TEG) in a subset of patients.

Main Results:

  • No patients showed abnormalities in standard coagulation tests, except for one elevated D-dimer.
  • All patients tested with ROTEM/TEG had normal results for both advanced and standard tests.
  • Copperhead envenomation did not lead to clinically significant coagulopathy in this series.

Conclusions:

  • Copperhead bites generally do not cause significant coagulopathy.
  • The utility of ROTEM/TEG for North American crotalid bites requires further investigation.