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

CCC Toxicology Series

CCC 700 6

Critical Care

Compendium

Chris is an Intensivist and ECMO specialist at The Alfred ICU, where he is Deputy Director (Education). He is a Clinical Adjunct Associate Professor at Monash University, the Lead for the  Clinician Educator Incubator programme, and a CICM First Part Examiner.

He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives. He was one of the founders of the FOAM movement (Free Open-Access Medical education) has been recognised for his contributions to education with awards from ANZICS, ANZAHPE, and ACEM.

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

On Bluesky, he is @precordialthump.bsky.social and on the site that Elon has screwed up, he is @precordialthump.

| INTENSIVE | RAGE | Resuscitology | SMACC

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