global spider and scorpion envenomation management

Question 1

T/F Anaphylaxis from an arthropod envenomation is not an indication for antivenom.

Answer 1

true

Question 2

what are chief complaints of widow spider bites?

Answer 2

symptoms start 15-60 minutes after bite, painful muscle cramps that start at bite site and moves towards the middle, may develop a rigid painful abdomen

Question 3

T/F you have a patient with significant symptoms that meets indications for antivenom but has a hx of asthma. You can still give one 2.5 milliliter vial of antivenom dissolved in one 2.5 ml vial of sterile water iv

Answer 3

false, asthma is a contraindication

Question 4

When patients do have significant symptoms meeting indications for antivenom you can administer______

Answer 4

expired antivenom, 2.5 ml of antivenom and 2.5 ml of sterile water

Question 5

Loxosceles reclusa in a venomous spider more commonly known as the ____, ____, and ______

Answer 5

brown recluse, violin spider, or fiddleback spider.

Question 6

Loxosceles venom is cytotoxic (toxic to living cells) and consists of two main constituents:

Answer 6

sphingomyelinase- D and hyaluronidase.

Question 7

a patient is bitten by a brown recluse, what treatment should be done on this patient?

Answer 7

wound care, tetanus prophylaxis, analgesics, and antipruritics as necessary. There is no antivenom available.

Question 8

T/F Tarantula bites are not dangerous to humans.

Answer 8

true

Question 9

what is the best way to remove tarantula’s barbed hairs from the skin?

Answer 9

Adhesive tape can be used to remove barbed hairs from the skin.

Question 10

Unlike other species of the spiders, funnel web spiders can bite tenaciously and may _________

Answer 10

have to be physically removed from the victim.

Question 11

Prehospital management for funnel web spiders bites consists of what?

Answer 11

pressure immobilization using an elastic crepe bandage applied tightly enough to limit lymphatic spread, but not to restrict blood flow.

Question 12

Scorpion venoms are complex and can include ____________

Answer 12

phospholipase, acetylcholinesterase, hyaluronidase, serotonin, and neurotoxins.

Question 13

The majority of scorpion envenomations can be adequately managed with _______

Answer 13

pain medications and routine wound management to include tetanus prophylaxis.

Question 14

For clinically significant envenomation, management is supportive and focused on the patient’s symptoms. ___________ are the first line therapy for sympathomimetic toxicity.

Answer 14

Benzodiazepines

Question 15

For severe reactions (i.e. respiratory distress, hypotension), immediately stop the antivenom infusion and treat using a _________

Answer 15

standard anaphylaxis protocol