Spider envenoming

OVERVIEW

  • in Australia the only two spiders of real importance = Funnel-web and the Red-Back
  • only these two can cause death or severe systemic illness

FUNNEL-WEB SPIDER

  • Sydney Funnel-web the most poisonous (160 km radius)
  • no death post the introduction of anti-venom
  • bites don’t always produce envenomation -> but if envenomed it can be rapidly fatal
  • venom = polypeptide which stimulates release of Ach at NMJ and catecholamines in CNS

CLINICAL FEATURES

  • nausea/vomiting, profuse sweating, salivation, abdominal pain
  • muscle fasciculation at bite site -> distal muscle groups
  • hypertension, tachycardia, hypersalivation, bronchorrhoea
  • coma, respiratory failure, pulmonary oedema, hypotension

MANAGEMENT

  • pressure-immobilisation dressing
  • anti-venom
  • supportive of vital organ function

RED-BACK SPIDER

  • distributed everywhere in Australia
  • no deaths since 1956

CLINICAL FEATURES

  • pin prick bit -> inflamed, severe pain -> radiates up limb
  • profuse sweating, headache, nausea, vomiting, abdominal pain, fever, hypertension
  • paraesthesia, rashes
  • can develop progressive muscle paralysis

MANAGEMENT

  • first aid not proven
  • ice for symptomatic relief
  • simple analgesia
  • anti-venom IM or IV

References and Links


CCC 700 6

Critical Care

Compendium

Chris is an Intensivist and ECMO specialist at the Alfred ICU in Melbourne. He is also the Innovation Lead for the Australian Centre for Health Innovation at Alfred Health and Clinical Adjunct Associate Professor at Monash University. He is a co-founder of the Australia and New Zealand Clinician Educator Network (ANZCEN) and is the Lead for the ANZCEN Clinician Educator Incubator programme. He is on the Board of Directors for the Intensive Care Foundation and is a First Part Examiner for the College of Intensive Care Medicine. He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives.

After finishing his medical degree at the University of Auckland, he continued post-graduate training in New Zealand as well as Australia’s Northern Territory, Perth and Melbourne. He has completed fellowship training in both intensive care medicine and emergency medicine, as well as post-graduate training in biochemistry, clinical toxicology, clinical epidemiology, and health professional education.

He is actively involved in in using translational simulation to improve patient care and the design of processes and systems at Alfred Health. He coordinates the Alfred ICU’s education and simulation programmes and runs the unit’s education website, INTENSIVE.  He created the ‘Critically Ill Airway’ course and teaches on numerous courses around the world. He is one of the founders of the FOAM movement (Free Open-Access Medical education) and is co-creator of litfl.com, the RAGE podcast, the Resuscitology course, and the SMACC conference.

His one great achievement is being the father of two amazing children.

On Twitter, he is @precordialthump.

| INTENSIVE | RAGE | Resuscitology | SMACC

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