M Anto ED prov fellow MVH 12 Jan 2017

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Presentation transcript:

M Anto ED prov fellow MVH 12 Jan 2017 Spider bites M Anto ED prov fellow MVH 12 Jan 2017

Intro Occurs in warmer times of the yr NSW: redback, funnel web Others do not cause serious systemic envenomation, and do not have AV

History Bite Spider Geographic location 1st aid Symptoms:

History Symptoms: Perioral paresthesia Tongue fasciculations Lacrimation Salivation Piloerection HT Nausea Dyspnoea Decr GCS

Tests None

Management Big black spider bites: Funnel web, may also be mouse or trapdoor Manage as suspected funnel web for 1st 4hrs Red back spider bites: - Severe pain, gradually increasing Other spiders: Symptomatic

Red back spider Pain increasing in severity Hrs to days Localised diaphoresis Non specific symptoms No deaths since 1950s Controversy re AV

Funnel web spider Painful Fang marks 1st aid: same as snake bite Observe 4hrs if asymptomatic Symptoms: Autonomic – sympathomimetic + cholinergic Neuromuscular excitation Cardiogenic – NCPO, hypotension Coma, MOF Nonspec – headache, abdopain, anxiety, N+V Give AV with any systemic sx

Resources Snakebite and Spiderbite Clinical Management Guidelines (3rd ed, 2014)