Centipedes bite

Tx

rinsing the bite site in cold water. If not too painful, ice the bite site.

papain, an enzyme that breaks down protein. Papain can be found in meat tenderizer and papaya. This deactivates the majority of the centipede venom's proteins

In Barbados, a folk remedy involves applying a freshly cut onion to the site of the injury "bite" for 10 minutes. Repeat until relief is obtained.

Arachnid Bites

Black Widow Spider

• presents with abd. pain, rigidity, and hypocalcemia; may presents like acute abdomen or perforated abd. organ but there is pain without tenderness.
• Treat with antivenin

Brown Recluse Spider

• presents with local necrosis, bullae, and dark lesions
• Tx - wound debridement; may add steroids and dapsone

Centruroides Scorpion

• common in U.S Southwest and Mexico
• neurotoxin causes local pain and paresthesia as well as severe cranial nerve defects (vision, eye movement, slurred speech)
• most severe effect = neuromuscular skeletal muscle dysfunction
• cholinergic excess causes bradycardia, secretion, and vomiting
• Look for h/o sting, pain on tapping site, and abnormal eye movements with normal mental status
• Tx - manage secretions, pain and airway; very severe cases get antivenin and atropine