a. Topical antiseptic & sterile dressing b. Possible antibiotics, rehydration, blood transfusions c. Dapsone (Avlosulfon)- sulfone i. Several ADR's d. Possible reconstructive surgery, debridement or skin grafts from necrotic tissue e. Supportive care for loxoscelism i. Include mgmt of renal failure, leukopenia, seizures, hemolytic anemia (from RBC destruction), thrombocytopenia ( PLTs) coma, fever, chills, NV, DIC & death C. Black Widow Spider “hourglass pattern” 1. Envenomation produces latrodectism (neurotransmitter is released from nerve terminals) a. Common Sx: severe abd pain, muscle rigidity, HTN, & N/V 2. Other sx: facial edema, ptosis (drooping eyelid), diaphoresis, priapism, respiratory difficulty, respiratory secretions, fasciculations (twitching), & paresthesias (painful tingling or numbness) 3. Effects are usually self-limited & generally resolve in a few days, however older adults w/other health issues (like CVD)= risk for complications 4. First Aid-Black Widow Spider Bite a. Apply an ice pack b. Monitor the individual for systemic toxicity i. Support the pt's airway, breathing, & circulation Transport the pt to a medical facility for ALS 5. Hospital Care-Black Widow Spider Bite a. Monitor VS (esp RR & BP) b. Opioids c. Muscle relaxants such as Valium, calcium gluconate d. Tetanus prophylaxis e. Antihypertensive agents as needed=monitor for seizures r/t fast in BP f. Tx of pulmonary edema, uncontrollable HTN, & shock g. Antivenom only used for severe reactions & pregos (to prevent contractions) D. Tarantula=Largest spiders of the arachnid class 1. Most bites result in only local effects 2. Tx-supportive mgmt, analgesics, immobilize & elevate involved extremity, tetanus prophylaxis a. Remove tarantula hairs ASAP thru repeated use of sticky tape, then thoroughly irrigate skin u.
E. Scorpion Sting 1. Effects of a sting that injects venom from a scorpion are typically self-limiting & best tx by analgesics, supportive mgmt, & basic wound care 2. One species of scorpion can inflict a sting associated w/a severe, potentially fatal systemic response (Bark Scorpion) 3. Interventions for Scorpion Sting a. VS assessment b. Continuous monitoring for sx progression c. Ice pack to sting site to control pain d. Analgesic & sedative agents e. Tx fever f. Tetanus prophylaxis g. Basic wound care F. Bees & Wasps 1. Bumblebees, hornets & wasps=can sting repeatedly; honey bee leaves stinger/venom sac in victum, killer bees attack for hours! 2. Potential for anaphylactic reaction with any 3. Emergency care=QUICKLY remove stinger (if present) w/tweezers or by gently scraping/brushing it off w/knife blade, credit care or needle & apply an ice pack 4. Advanced emergency care in a hospital=ensure airway, breathing, & circulation are maintained 5. "EpiPen" admin of epinephrine w/the click of a button=esp. valuable for allergic pts a. IV Epi is much stronger than IM=monitor pt for 1 hr after admin of IV q10-15m G.
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- Winter '16
- Nursing, triage, A. Maintaining Pt, emergency pt mgmt