Antivenom is indicated for bites caused by Cobra, Common Krait, Russell’s Viper, and Saw-Scaled Viper. The patient must present with one or more of the following visible clinical signs and symptoms of envenomation:
Local Envenomation:
- Presence of bite marks with or without oozing of blood, blistering, and change in color of skin.
- Rapidly progressive or massive swelling involving more than half of the bitten limb within a few hours of the bite (without tourniquet).
- Development of enlarged tender lymph nodes draining the bitten part within a couple of hours after the bite.
Systemic Envenomation:
- Neurotoxic Syndrome: Signs of neuro-paralysis like blurring of vision, double vision, difficulty in swallowing, sleepy feeling, drooping of head, slurring of speech, indistinct voice, shallow breathing, ptosis, ataxia, respiratory paralysis, and generalized flaccid paralysis.
- Hemotoxic Syndrome: Spontaneous systemic bleeding, nausea, vomiting, abdominal pain, and tenderness suggestive of gastrointestinal or retro-peritoneal bleed and/or renal damage, coagulopathy detected by 20 min WBCT with or without external bleeding and shock.