Once at a healthcare facility, support must be provided until the venom is metabolised and the victim can breathe unaided, especially if no species-specific antivenom is available. Given that the toxins alter acetylcholine transmission which causes the paralysis, some patients have been successfully treated with cholinesterase inhibitors, such as physostigmine or neostigmine, but success is variable and may be species-dependent, as well. If death occurs, it typically takes place about 6-12 hours after the krait bite, but can be significantly delayed. Cause of death is usually respiratory failure—suffocation by complete paralysis of the diaphragm. Even if patients make it to a hospital, subsequent permanent coma and even brain death from hypoxia may occur, given the potential for long transport times to get medical care.