OSSSC Nursing Disease Guide

Emergency · High priority

Snakebite envenoming

Core disease facts with the linked government programme, prevention and treatment or cure reality.

TypeToxin-mediated medical emergency — venom causes illness; it is not an infection.

Image-based identification

Official ICMR poster showing Indian cobra, common krait, Russell's viper and saw-scaled viper
What to identifyIndia's Big Four are the Indian cobra, common krait, Russell's viper and saw-scaled viper. Learn the names for the exam; never handle a snake or delay treatment to identify it.Image credit: ICMR–NIRRCH National Snakebite Project

Government programmes, schemes and services

  • Programme: National Programme for Prevention and Control of Snakebite Envenoming: Aims to reduce snakebite deaths, disability and complications by improving first aid, trained treatment, emergency referral, antivenom access, surveillance and community awareness.
  • Action plan: National Action Plan for Prevention and Control of Snakebite Envenoming: The 2024 action plan coordinates health services, ambulance/referral networks, venom and antivenom systems, surveillance, research and prevention across sectors.

Prevention

  • Prevent: Wear footwear and use a light outdoors at night; keep surroundings clear; after a bite, keep the person still, immobilise the limb and transfer urgently.

Treatment and cure reality

  • Treat: Antivenom is the specific treatment for systemic envenoming. Airway support, treatment of shock or coagulopathy, and monitoring for kidney injury may be lifesaving.

Must remember

  • Programme: National Programme for Prevention and Control of Snakebite Envenoming; its national action plan was launched on 12 March 2024.
  • Indian “big four”: Indian cobra, common krait, Russell’s viper, and saw-scaled viper.
  • First aid: Reassure, keep the patient still, immobilise the bitten limb, remove rings/tight items, and transport urgently to a capable health facility.
  • Do not: Cut, suck, burn, massage, apply ice/chemicals, or use a tight arterial tourniquet.
  • Neurotoxic clues: Ptosis, diplopia, bulbar weakness, respiratory paralysis—classically cobra/krait patterns.
  • Haemotoxic clues: Bleeding, incoagulable blood, shock, and kidney injury—classically viper patterns.
  • Antivenom: The only specific treatment for systemic envenoming; it is not indicated merely because a harmless snake bit the patient.
  • Skin-test trap: Routine skin testing does not reliably predict antivenom reactions and should not delay indicated treatment.
  • Nursing priority: Airway and breathing support, rapid referral, monitoring for coagulopathy/renal injury, and preparedness to manage anaphylaxis.