Tarantula Envenomation Treatment & Management
- Author: Scott D Fell, DO, FAAEM; Chief Editor: Joe Alcock, MD, MS more...
Capture the offending arachnid for identification if it is possible to do so safely.
Begin supportive therapy for patients who are having a rare allergic reaction or anaphylaxis.
Following ocular exposure, place a protective shield over the eyes to prevent the patient from rubbing the eyes and possibly driving hairs deeper.
Emergency Department Care
A patient with anaphylaxis or allergic reaction requires prompt supportive care and attention to the ABCs.
In patients with severe reaction, establish an intravenous line, provide supplemental oxygen, and place them on a cardiac monitor.
Protect areas of localized dermatitis and allergic reactions with appropriate local wound care, including wound cleansing and ice to decrease inflammation.
Determine tetanus immunization status and provide prophylaxis as needed.
Treat pruritus and erythema with antihistamines and corticosteroids.
Administer parenteral or enteral analgesics to relieve severe pain.
Ocular injury caused by tarantula hairs can be complicated and requires ophthalmologic consultation.
After initial evaluation, patients should be treated with a topical broad-spectrum antibiotic.
Topical steroids are required for patients with panuveitis or keratoconjunctivitis; they should be prescribed only after consultation with an ophthalmologist.
As with skin contact, tetanus prophylaxis is indicated when the eye is involved.
Patients can develop long-term inflammatory changes in the eye exposed to tarantula hairs, and definitive diagnosis of retained hairs cannot always be made by routine ED slit-lamp examination. Consulting an ophthalmologist is mandatory in such exposures.
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