Typically, victims start to complain of severe abdominal cramps accompanied by progressive muscular paralysis, frequently starting with ptosis. As no local symptoms are seen, a patient should be carefully observed for tell-tale signs of paralysis (e.g. the onset of bilateral ptosis, diplopia, and dysphagia), and treated urgently with antivenom. Frequently, little or no pain occurs at the site of a krait bite, which can provide false reassurance to the victim. The major medical difficulty of envenomated patients is the lack of medical resources (especially intubation supplies and mechanical ventilators in rural hospitals) and the ineffectiveness of the antivenom.