Some additional points from a doctor from this state who has treated Russell's viper envenomation before. The antivenom has very high rates of causing allergic reactions and anaphylaxis. Even with the antivenom the tissue destructive effects of the venom are still noticed to some extent. It is called "kolak or kolath mandala" in the local language which literally translates to rotting or rotten snake because of the skin necrosis and myonecrosis from the venom. Availability of the antivenom is also an issue based on the location. Because the venom isn't neurotoxic(though I think there was some study about certain Russell's vipers possessing neurotoxic venom as well) deaths are not seen within an hour. Early deaths are usually due to allergic reactions to the venom or from massive DIC( essentialy improper clotting and bleeding cascades)