Is the patient envenomed?
Is it likely that a clinically relevant injection of venom has taken place?
- time of the bite,
- local pain,
- nausea, vomiting.
- state of consciousness (restlessness, sleepiness, coma).
- blood pressure/pulse,
- breathing (respiratory rate).
- local swelling,
- local redness,
- eyes (contact with urticating hairs): conjunctivitis, keratitis, iritis, chorioretinitis.
- increased bronchial secretion,
- abdominal pain, board-like abdominal rigidity (differential diagnosis acute abdomen)
- bradycardia/tachycardia/cardiac arrhythmia,
- arterial hypotension/hypertension,
- clinical signs of pulmonary oedema,
- clinical signs of shock,
- generalised muscle pain and cramps,
- muscle weakness.
Record and measure:
- blood sugar.
Exclusion of a clinically relevant systemic reaction
Monitoring for signs and symptoms of systemic envenoming (see above) for 12–24 h.