Snake Venom Antiserum

• Envenomation caused by snake bites

Snake Venom Antiserum is indicated for bites caused by Cobra, Common Krait, Russell's Viper and Saw-Scaled Viper, where the patient presents with one or more of fallowing 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. ... Read moreSnake Venom Antiserum is indicated for bites caused by Cobra, Common Krait, Russell's Viper and Saw-Scaled Viper, where the patient presents with one or more of fallowing 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 few hours of bite (without tourniquet) Development of enlarged tender lymph nodes draining the bitten part within couple of hours after bite Systemic envenomation- 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. 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. Immediate actions and first aid: 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.

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There are no known contraindications for the administration of Snake venom antiserum. Proper precautions are necessary while dealing with persons with a known hypersensitivity to constituents of product. Few doctors prefer to premedicate patients with Inj. Adrenaline 0.25 ml s/c to prevent possibility of adverse reactions. In haemotoxic bites, IM injections should be avoided till correction of coagulopathy to avoid formation of haematoma and oozing of blood. In patients having tourniquet, it should be released slowly only after start of Snake venom antiserum administration.

Snake venom antiserum is a sterile preparation containing antitoxin globulins and their derivatives. It is the only specific treatment for venomous snake bites.

Risk of increased severity of acute anaphylaxis when used with β-adrenergic blockers.

Snake venom antiserum being derived from equines is heterologous to human can give either early or late reaction. Adrenaline should be always kept handy, before starting the dose of Snake venom antiserum. Reduction in adverse reactions has been reported by use of adequate dilution of Snake venom antiserum with saline and controlling rate of infusion.

Considering the risk associated with snake bite envenomation, pregnancy is not a contraindication for the administration of Snake Venom Antiserum subsequent to bite.

Proper skin test should be done prior to parenteral admin of the antivenom to identify risk of anaphylaxis.