Snake bite protocol India 2009

20-minute Whole blood clotting test 20 WBCT 10 ml blood in a plain vial for 20mts if not clotted
viper -Give ASV if significant limb swelling or positive 20 WBCT +- 8= 10 vials in 1hr iv

Same dose in children

Repeat dose for hemotoxic 6-hour rule max dose 30 vials

Repeat dose in Neurotoxic 1-2-hour rule max is 20 vials

No ASV test dose. If adverse reaction stop infusion IM adrenalin 0.5 mg - restart ASV after
chlorpheniramine and hydrocortisone iv .

Neurotoxic bite neostigmine test Neostigmine 0.5 mg IM with atropine 0.6 mg i/v .

If patient unable to perform a neck lift test should be transferred to facility for mechanical ventilation

Not to use botropase hemocoagulase to control bleeding in hemotoxic bite as it produce consumptive
coagulopathy

In DIC of hematotoxic bite no role for heparin