Black Widow Spider Bite Signs Symptoms and The Management Approach

11 May 2019 03:54 7
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Black Widow Spider Bite Signs Symptoms and The Management Approach Clip Video - Black widow spiders usually do not bite humans until provoked. It is not necessary that all bites cause pain. Some bites go unnoticed. Toxin injected by the spider affects the nervous system. After some time the bitten area shows signs of inflammation. Pain and swelling can be accompanied by tremors, muscle weakness, nausea, vomiting, and mild to severe abdominal discomfort. To the provider, the abdominal pain may seem like appendicitis or pancreatitis. The abdomen may be rigid like a board but non-tender on palpation.

Treatment is as follows
Clean the bite area with soapy water.
Apply cold compresses to the bite; it will limit the swelling and reduce the pain.
In case of a bite on a limb, elevate this limb.
Over the counter pain reliever, acetaminophen (Tylenol, others) or ibuprofen (Advil, Mortin, etc.) can be taken. Antihistamine (Benadryl) can be taken as well.
Tetanus immunization should be checked and updated if necessary with a booster.
Basic or advanced life support may be needed in case of severe symptoms.
Nitroprusside may be needed for hypertensive episodes due to envenomation. (Venom injection process.)

Antivenin can be given; however, it can cause a severe allergic reaction as it contains whole immunoglobulin G from horses. Deaths have been reported in the patients of asthma receiving antivenin. So, don't rush to antivenin as the other medications usually perform very well without endangering the patient's life.

Calcium gluconate used to be the treatment for abdominal pain. However, studies have shown that it is ineffective. IV opioids with or without benzodiazepines (usual diazepam) have proved to be the most effective. 55% of patients felt better with the IV opioids, 70% felt better with IV opioids plus benzodiazepines. 100% of the patients on antivenin felt better.

General approach
References: https://www.mayoclinic.org/diseases-conditions/spider-bites/diagnosis-treatment/drc-20352377

Calcium gluconate is not an effective treatment for the black widow spider related abdominal discomfort: https://www.mdedge.com/familymedicine/article/64925/pain/which-treatments-relieve-painful-muscle-spasms-black-widow-spider

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Tags: DrBeen, DrBeen Lectures, Online Medical Lectures, MedLife, Medical School, Medical Videos, USMLE, Step 2, USMLE Step 2, Step 1, USMLTE Step 1, Dr. Mobeen Syed, Black widow spider bite, Calcium gluconate, Verapamil, benzodiazepines, IV Opioides, Acetamoniophen, Ibuprofen, Anti-histamine

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