<p>Snake Venom Antiserum is indicated for bites caused by Cobra, Common Krait, Russell&#39;s Viper and Saw-Scaled Viper, where the patient presents with one or more of fallowing visible clinical signs and symptoms of envenomation &ndash;<br />
<br />
Local envenomation-</p>

<ul>
	<li>Presence of bite marks with or without oozing of blood, blistering and change in color of skin.</li>
	<li>Rapidly progressive or massive swelling involving more than half of the bitten limb within few hours of bite (without tourniquet)</li>
	<li>Development of enlarged tender lymph nodes draining the bitten part within couple of hours after bite</li>
</ul>

<p>Systemic envenomation-</p>

<ul>
	<li>Neurotoxic syndrome- signs of neuro-paralysis like blurring of vision, double vision, and difficulty in swallowing, sleepy feeling, drooping of head, slurring of speech and the voice may become indistinct with shallow breathing, ptosis, ataxia, respiratory paralysis and generalized flaccid paralysis.</li>
	<li>Hemotoxic syndrome- spontaneous systemic bleeding, nausea, vomiting, abdominal pain and abdominal tenderness suggestive of gastro-intestinal or retro-peritoneal bleed and/or renal damage, coagulopathy detected by 20 min WBCT with or without external bleeding and shock.</li>
</ul>

<p><strong>Immediate actions and first aid:</strong>&nbsp;Quick and positive measures should be taken to meet the emergency. Do not try to catch or kill the snake without proper tools and avoid unnecessary exposure to snack. Patient should be removed to a well-ventilated and quiet place and restrict his/her movement. Patient should be reassured to overcome fear. Immobilize the bitten part by applying immobilization bandage as done for a fracture and bitten part is kept below heart level. Ligation by applying tourniquets should be avoided, however, if applied it should be tied at moderate distance above the bitten part to prevent the entry of venom into the circulation. Patient should be immediately taken to nearby medical centre for treatment without loss of time.</p>