Exploring the utility of point-of-care testing for diagnosing snake envenomation in Australian snake bites: A scoping...

Most snake bites in Australia do not result in envenomation. However, when it does occur, envenomation can lead to a range of clinical syndromes, depending on the snake species involved. Diagnosis of envenomation, which relies primarily on laboratory investigations, poses a significant challenge when rapid identification of envenomation is essential for the timely administration of antivenom. Finding a solution to this challenge could enable earlier diagnosis and subsequent treatment of snake envenomation. This review assesses the existing literature on point-of-care testing methods for diagnosing snake envenomation across Australia.

Six relevant databases were searched using appropriate subject headings and keywords, related to "snake" AND "bite" AND "Australia" with no time or language restrictions. Two reviewers screened titles and abstracts and full text articles. Data from included studies was extracted in duplicate.

1,260 articles were initially identified following removal of duplicates. After screening for eligibility, 12 relevant studies were identified. These articles explored four key areas of point-of-care testing in snake envenomation diagnosis: venom detection, coagulopathy detection, biomarker detection and cardiac assessment. No point-of-care test was found to sufficiently confirm envenomation to guide administration of antivenom in those with a suspected snake bite in Australia.

This review underscores the need for continued research to explore novel approaches for the rapid diagnosis of snake envenomation. Improved diagnostic tools could enhance patient outcomes and potentially allow rural and remote areas without laboratory facilities to diagnose or rule out envenomation without patient transfer. However, the current literature is limited, and existing point-of-care methods lack sufficient accuracy to guide clinical practice.