UNCONTROLLED WHEN PRINTED
Quick Chart
Introduction
  • Bites from spiders, bees, ticks and other insects can cause redness and pain locally.
  • Insect bites can be painful, but rarely result in a serious reaction, unless the patient has an allergy to the venom, previously known or unknown.
Clinical Presentation
  • In susceptible individuals allergy/anaphylaxis may occur. Watch for respiratory and gastrointestinal symptoms, and treat for anaphylaxis if identified. Follow CPG for treatment of anaphylaxis.
  • Intense localised pain, redness and swelling at the site. Pain may become intense and spread.
  • Nausea, vomiting and abdominal pain.
  • Tender glands in the groin or armpit of envenomed limb.
Exclusion Criteria
Exclusion Criteria
Risk Assessment
  • Venom of the Redback spider can pose a threat to life in children.
  • Venom from spider and insect bites spreads slowly and may take up to 3 hours to develop.
  • Pressure at the site of the bite will increase pain.
  • The Australian funnel-web spider is the only spider in Australia which can cause a threat to life in adults, but is not known to be found in WA.
Management
Primary Care
Note: Pressure Immobilization Technique (PIT), is not to be used on spider or insect bites, except the Australian funnel-web spider.
  • Primary Survey
  • Keep patient at rest and prevent movement
  • Management of sting:
    • In bee sting, remove sting as quickly as possible, to prevent further venom injection through the sting
    • In tick, if no history of allergy, remove immediately
    • If known allergy, tick must remain in place to prevent further envenomation occurring on removal. The hospital will kill the tick in position prior to removal
  • Use cold compress to reduce pain and swelling at site
  • Conduct Vital Sign Survey
  • Observe patient closely for signs of anaphylaxis; if identified, treat accordingly.
  • Be alert for rapid deterioration
Intermediate Care (EMT / Level 2)
  • Consider pain relief if cold compress ineffective
  • Consider applying cardiac monitor if trained and authorised
  • Monitor patient persistently, recording full observations every 10 minutes (or 5 minutes if time critical)
  • Transport Priority 1 if patient time critical, pre-notifying receiving facility
Advanced Care (AP)
  • Consider vascular access
  • Consider alternative pain relief if cold compress ineffective
  • Consider applying cardiac monitor if trained and authorised
  • Monitor patient persistently, recording full observations every 10 minutes (or 5 minutes if time critical)
  • Transport Priority 1 if patient time critical, pre-notifying receiving facility
Critical & Extended Care (CCP, PSO)
  • As per Advanced Care (AP) guidelines
Additional Information
  • N/A

References
References

Document Control


Directorate
Clinical Services

Responsible Manager
Head of Clinical Services

Published Date

Review Date

St John WA © Copyright 2020. All Rights Reserved

Privacy Policy | Copyright Statement & Disclaimer