Special situations (children, elderly, pregnancy and underlying diseases)

These victims carry high morbidity and mortality. Hence, they need close monitoring and management irrespective of degree of envenoming. It has been found that admitting these patients to an Intensive Care Unit without delay would improve the outcome. The dose and the regimen of antivenom remain the same as in healthy adults. However, volume of infusion solution should be reduced according to body weight, degree of dehydration or underlying disease. Adrenaline shouldn’t be used as prophylaxis in antivenom reactions. Total fluid requirement should be adjusted to suit individual patient. In pregnancy saving the life of the mother is the high priority.