Respiratory obstruction and failure are the greatest immediate concern. Should the patient develop difficulties in breathing or airway impairment, respiratory support will be required. If the tongue, jaw or pharynx become paralyzed, insert an oral airway. Make sure adequate suction equipment is available and operative. Fluid management is very important in snake bite cases.
Intravenous administration is always the most appropriate route.
Watch for airway compromise and aspiration. Alcohol should also be avoided. Tetanus prophylaxis should be current. Antibiotics are NOT recommended prophylactically. If the patient is in extreme fluid load, antivenom may be delivered at more concentrated volumes until the patient is in appropriate fluid balance.