Spider & Insect Bites

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

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)