Snake Bite Management

A 35-year-old woman from Madhya Pradesh is brought to the hospital 6 hours after a cobra bite to her right hand. She has local swelling up to the elbow, but her vital signs are stable and she is fully conscious. Neurological examination is normal. Investigations: PT 14 seconds (control 12 seconds), aPTT 36 seconds (control 32 seconds), fibrinogen 250 mg/dL, platelet count 2.5 lakh/μL. 20-minute whole blood clotting test shows normal clot formation. What is the most appropriate next step in management?

A 28-year-old farmer from rural Maharashtra presents to the emergency department 4 hours after a snake bite to his left foot while working in the field. On examination, he has local swelling extending up to the knee, with fang marks visible. His vital signs are stable. Blood investigations show: PT 18 seconds (control 12 seconds), aPTT 45 seconds (control 32 seconds), fibrinogen 80 mg/dL (normal 200–400), platelet count 1.2 lakh/μL. 20-minute whole blood clotting test shows no clot formation. What is the most appropriate immediate management?

Which of the following antivenoms is indicated for the management of viper bite in India?

A 28-year-old male farmer from rural Maharashtra presents to the emergency department 4 hours after a snake bite on his left foot while working in the field. He reports severe local pain, swelling extending above the knee, and two episodes of spontaneous bleeding from the bite site. On examination, the limb is grossly swollen with blistering and tissue necrosis around the bite. Blood investigations show: PT 18 seconds (control 12), aPTT 45 seconds (control 32), fibrinogen 80 mg/dL (normal 200–400), platelets 45,000/μL. The 20-minute whole blood clotting test shows no clot formation. What is the most appropriate immediate management?

A 35-year-old woman from rural Tamil Nadu is brought to the hospital 6 hours after a cobra bite on her right hand. She complains of progressive weakness and difficulty in swallowing. On examination, she has bilateral ptosis, dilated pupils, and inability to open her mouth fully. Respiratory rate is 28/min with shallow breathing. Vital signs: BP 110/70, HR 88, SpO₂ 92% on room air. Coagulation profile is normal. The 20-minute whole blood clotting test is negative. What is the most appropriate immediate intervention?