Although neurotoxic snakebite mortality is exceeded by that from viperine species it remains a significant contributor to total figures. The rapidity of onset of life threatening respiratory compromise in a developing world context with little access to mechanical ventilation contributes to poor outcomes, particularly amongst children. The majority of hospitals in the developing world are primary care centers, with limited facilities, and yet are close to the scene of the bite. Most of the textbooks used in medical education are written from a tertiary hospital perspective with the assumption that access to a mechanical ventilator is available. Consequently guidelines for primary care hospitals are inapplicable and result in most patients being transferred to other hospitals in sub-optimal conditions. This paper examines neurotoxic snakebite and recommends management techniques, use of anti snake venom and support drugs and the various methods of airway support that can be sourced or improvised in a primary care setting.

Key Words: Snake Bites, Neurotoxicity, Airway Management, Developing World, India