Pathology

Specimen Type: Swab from bite site is the best specimen, followed by urine

Please phone the laboratory to arrange the pick up of the Snake Venom Collection Kit

Box Hill Laboratory – 9895 3489

Angliss Laboratory – 9764 6136

Maroondah Laboratory– 9871 3572

The specimen(s) must be collected in the Emergency Department (see following instruction), labelled correctly and sent to Pathology laboratory for analysis.

Results are reported as either Positive or Negative.

Positive results are categorised into one of the five main medically important snake groups, namely Tiger, Brown, Black, Death Adder and Taipan immunotypes.

Toxic Range:

A positive result for venom from the bite site does not mean the patient has been significantly envenomed

A positive result from the bite site is not an indication to give antivenom. It is an indication of the type of antivenom to be given if the patient needs antivenom therapy based on clinical or laboratory test result evidence.

The collection kit from Pathology consists of two parts;

Swab and collection container

Reagents

Bite Site Swab:

Venom may be detected in a swab from the bite site from skin surrounding fang puncture marks or from tissue exudate gently squeezed from the punctures.

Carefully remove the lid and dropper from an unused Yellow Sample Diluent vial and moisten the swab in the diluent.

Thoroughly swab the bite site. Gently squeeze the bite site and swab any tissue exudate released. Do not squeeze roughly.

Thoroughly agitate the swab in the diluent. The swab may be then removed and discarded or snapped off leaving the cotton section in the vial.

Replace the dropper and lid, and mix well by inverting several times.

Affected Bandage or Cloth Specimen:

Cut a small piece of the material (1-1.5cm2) that looks to have blood or tissue exudate on it.

Carefully remove the lid and dropper from an unused Yellow Sample Diluent vial and using forceps or tweezers place the affected material into the vial.

Replace the dropper and lid, and mix well by gently inverting several times.

Alternatively, soak the affected material in approximately 1mL of water or saline to release any venom.

Carefully remove the lid and dropper from an unused Yellow Sample Diluent vial and transfer the washings using a disposable pipette or syringe.

Replace the dropper and lid, and mix well by gently inverting several times.

Urine Specimen:

Carefully remove the lid and dropper from an unused Yellow Sample Diluent vial and fill to the neck with test urine using a disposable pipette or syringe.

Replace the dropper and lid, and mix well by gently inverting several times.

Plasma or Blood Specimen:

Note: Erroneous reactions resulting in an invalid assay may occur if a whole blood specimen is tested.

Blood is not recommended to be tested, but can be if this is the only option.

Plasma or serum is the preferred blood based sample, however, whole anticoagulated blood is recommended in urgent situations as this sample does not require centrifugation and is therefore available more rapidly. A plasma or whole blood sample should be used if a bite site or urine specimen is not available.

Remove the lid and dropper from an unused Yellow Sample Diluent vial and fill to the neck with serum, plasma or whole blood using a disposable pipette or syringe. Heparin, EDTA, oxalate or citrate anticoagulated samples may be used.

Replace the dropper and lid, and mix well by gently inverting several times.