One should anticipate using 5-40 vials for moderate to severe bites. It is advisable to check periodic serum and urine analyses during therapy as outlined above. It is always best to keep the patient in an Intensive Care setting until free of major symptoms for 24 hours. The patient should be observed in the hospital for at least 24 hours after the major symptoms abate. It is important to note the continual progression of symptoms throughout the course of therapy, and give additional antivenom as necessary to titrate these symptoms.
Fluid management is very important in snakebite cases.
The patient should be well hydrated and a brisk urine output maintained. Alcohol should also be avoided. In cases of intense colic, the use of antispasmodics may be considered. If the patient remains oligouric, dialysis should be considered early. Tetanus prophylaxis should be current.