Rare systemic s/s include: rash, fever, chills, n/v, malaise and joint pain Severe cases may include: hemolytic reactions, renal failure, pulmonary edema, cardiovascular collapse and death o Interventions Prehospital care: Apply cold compress over the site intermittently until there is no further progression of the wound o Cold helps decrease the enzyme activity of the venom and may limit tissue swelling and necrosis (heat increases the activity potentially worsening the wound) Recommended actions: elevate extremity, local wound care and rest
Hospital care: Supportive care and ongoing monitoring for complications Topical antiseptic and sterile dressing necessary if the wound appears infected Wound cultures and antibiotics may be indicated Tetanus prophylaxis is recommended Surgeon eval if wound requires interventions beyond conservative management s/s of loxoscelism: o fever and chills, n/v, renal failure, hemolytic anemia, thrombocytopenia, DIC, and death critical care management of loxoscelism: aggressive hydration, blood transfusions, hemodialysis, and supportive therapies to prevent further deterioration and promote recovery Black Widow Spider o Pathophysiology Found in every US state EXCEPT Alaska Found in cool, damp environments like outdoor log piles, vegetation, and rocks; commonly inhabit barns, sheds and garages Female: shiny black w/ red hourglass pattern on her abdomen Male: smaller in size, lighter in color w/ white and gray markings; hourglass pattern is faint Have neurotoxic venom Initial bite ranges from nearly painless to sharply painful Notices small papule or small, red punctate mark (some people have intense pain that seems out of proportion to the lesion) In many cases symptoms do not progress beyond a local reaction in the area of the bite site; if systemic s/s occur they generally develop w/in 1 hour and involve the neuromuscular system o Assessment Black widow spider venom produces latrodecitism (the venom causes neurotransmitter release from nerve terminals)
s/s: severe abd pain, muscle rigidity and spasm (spasms include large muscles of the abdomen, back and limbs), hypertension, n/v (may be misdiagnosed because s/s are typical of peritonitis) other problems include: facial edema, ptosis, diaphoresis, weakness, increased salivation, respiratory difficulty from increased secretions, fasciculations (twitching), and paresthesias bite effects are self limiting and resolve within a few days older adults with other health problems like cardiovascular disease are at much higher risk for complications o interventions prehospital priority: apply an ice pack because cold application decreases the action of the neurotoxin if s/s of systemic toxicity occur: support the airway, breathing and circulation hospital care closely monitor v/s w/ special attention to BP and resp function supportive therapy: administration of opioids and muscle relaxants
You've reached the end of your free preview.
Want to read all 26 pages?
- Winter '16
- Cardiac arrest, pulmonary edema, Edema, Hospital Care