Carefully note the progress of any paralysis which may be present. Respiratory obstruction and failure are the greatest immediate concerns. 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.
The patient should be well hydrated, and a brisk urine output maintained. Watch for airway compromise and aspiration. 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.