Hera Lai's 10 year old child presented in casualty with snakebite since six hours. On examination no systemic signs are found and lab investigation are normal except localized swelling over the leg of < 5 cm. Which of the following is the next step in management?
The indications for antivenin are: Rapidly progressive and severe local findings (soft tissue swelling, ecchymosis, petechiae etc). Manifestations of systemic toxicity (signs and symptoms of laboratory abnormalities). Because both these conditions are absent, the antivenin therapy should be withheld and the victim should be closely monitored for vital signs, cardiac rhythm and oxygen saturation. Ref: Harrison's Principles of Internal Medicine, 15th Edition, Page 2545
I/V antivenom
Incision and suction of local swelling
Subcutaneous anti venom at local swelling
Observe the patient for progression of symptoms and wait for antivenom therapy