A general workup for a critically ill patient is recommended to rule out other etiologies for acute paralysis and respiratory failure. Imaging studies are generally not helpful. A plain film of the puncture site may be indicated to rule out a foreign body. What constitutes proper wound care is controversial. Perform local suction without incision or local sequestration of the venom by applying a constricting band proximal to the injury.
Treatment is supportive.
Provide endotracheal intubation and ventilatory support until the venom has worn off, usually within 4-10 hours. Confirm that the patient's tetanus status is current. No antivenin is available. A general surgery consult may be indicated for wide excision of the wound. However, this has not proven to improve outcome.