Diagnosis & Treatment — First aid / lay people
- loss of consciousness.
- Calm the patient.
- Place the patient in a stable lateral position, or possibly the Trendelenburg position (shock position).
Anxiety (fear of death) plays an important role following accidents with venomous animals and has an additional negative influence on the clinical course after an accident.
Loss of consciousness after an accident with a venomous animal can have many causes. It is important to place the patient in a stable lateral position to avoid aspiration. If peripheral circulatory failure is present, the shock position may improve the patient's condition. If resuscitation is necessary, it is only in exceptional cases that lay people will be sufficiently well trained to be able to intervene.
How can absorption and circulation of the venom be delayed?
Spider bites from which neurological effects can be expected: compression-immobilisation method or comparable methods.
Immobilisation of the bitten extremity with a splint/sling.
The compression-immobilisation method was tested experimentally in Atrax sp. envenoming and proved beneficial in the treatment of patients (Hartman and Sutherland 1984, Sutherland and Duncan 1980).
Atrax sp., Hadronyche sp.: It is imperative to apply pressure-immobilization as early as possible, ideally within 10 minutes after the bite. The bandage must remain in place until the envenomation syndrome has completely resolved. The first aid knowledge of the population is dangerously deficient (Miller et al 2000).
This method may also makes sense in envenoming by other spiders that cause neurological effects (Latrodectus sp., Phoneutria sp.) (Warrell and Fenner 1993).
In contrast, the use of any form of compression bandage for bites caused by spiders that inject venom with a local necrotic effect is problematic, as there is a risk that it may cause additional local tissue damage.
Bite wounds including the surrounding reaction
Time between the bite and death
Atrax robustus: 15 min–6 days (Sutherland 1983).
This information underlines the need for an efficient first aid method.