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An indigenously developed tele-ICU model to treat severe cases of envenomation in remote regions in India
  1. Lokesh MB1,
  2. Dileep Singh Parmar2,
  3. Sukhdev Singh3 and
  4. Carl Britto4
  1. 1Cloudphysician Healthcare Pvt Ltd, Bengaluru, India
  2. 2Aastha Health Care, Gandhinagar, Gujarat, India
  3. 3LHDM & Dr Prem Hospital, Panipat, Haryana, India
  4. 4Division of Critical CareDepartment of Anaesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
  1. Correspondence to Dr Carl Britto; carl.britto{at}


In cases of severe envenomation due to snakebites, patients require antivenom, intensive care management, including respiratory support, haemodynamic monitoring and renal replacement therapy. Early recognition and treatment of complications such as acute kidney injury, rhabdomyolysis and coagulopathy are important to improve outcomes.

Tele-ICU models can play a critical role in providing access to critical care expertise and nuanced support to remote healthcare facilities that may not have the necessary resources or expertise to manage complex cases of envenomation. With the help of telemedicine technology, remote intensivists can provide timely guidance on diagnosis and ongoing management, improving the quality of care and outcomes for patients. We discuss two patients in resource-constrained regions of India with severe envenomation who were managed with tele-ICU support.

  • Global Health
  • Adult intensive care
  • Medical management

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  • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms and critical revision for important intellectual content: LMB, DSP, SS and CB. The following authors gave final approval of the manuscript: LMB, DSP, SS and CB.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.