First aid for spider bite

Not all spider bites have major signs and symptoms. Some common features to expect following a spider include:

• Pain at the spider bite site
• Burning sensation in the area of the spider bite site
• Swelling on spider bite site
• Blistering on spider bite site
• A blister surrounded by a bruise or reddish skin colour (similar to a bull’s-eye). The blister may rupture and form a skin ulcer that later scars.
• Blisters can rupture and ooze pus or blood
• An itchy papule or wheal may develop and persist for several days around the site of the spider bite
• Allergic reactions of the skin on or around the site of the spider bite
• Hives (urticaria), which are itchy, raised welts found on the skin

Signs and symptoms of a possibly poisonous spider bite:

• Difficulty breathing
• Droopy eyes or swollen eyes
• Headache
• Increased saliva production
• Nausea and vomiting
• Painful muscle cramps
• Stiffness in the stomach, shoulders, chest and back
• Profuse sweating
• Itchy skin rash
• Severe headache within minutes or hours after the bite which can last for up to a week
• Hardened skin at the bite area within 30 minutes of the bite
• Fatigue
• Cognitive impairment or fogging of memory or consciousness

Signs and symptoms of severe allergic reaction or anaphylaxis:

• Sudden and severe swelling around eyes and lips
• Swollen tongue
• Bluish colouration of the lips or fingernails
• Sensation of constricting airways and/or difficulty breathing
• Respiratory or breathing problems
• Shortness of breath
• Laboured breathing
• Wheezing
• Not breathing
• Choking
• Noisy breathing
• Noisy breathing that ceases and is followed by an absence of any breath sounds
• Drooling saliva
• Generalised edema or swelling of the body
• Hives or urticaria rash
• Intense distress
• Itching in the throat or mouth

Any indication of a poisonous spider bite or severe allergic reaction, or anaphylaxis, requires immediate medical assistance at the nearest healthcare facility.

Following are the first aid steps to take following a spider bite:

• Try to calm the patient. 
• Clean the spider bite site with water and soap thoroughly. Gentle scrubbing is recommended.
• After cleansing the site, apply a clean ice pack or clean cloth dipped in cold water to the spider bite site for at least 15 minutes every hour. This will reduce or prevent the bite from becoming swollen and painful. This should be done till the pain and discomfort become manageable.
• An antibiotic ointment, like neosporin, should be applied to the spider bite to prevent bacterial infection.
• If the pain or discomfort is too much, over-the-counter painkillers like NSAIDs (such as paracetamol) should be taken.
• If a wheal (raised circular lesion) that radiates outward from the site of the spider bite appears, antihistamine medicines like levocetirizine should be taken.
• If intense itching occurs, an oral antihistamine (like levocetirizine) should be taken.
• Spider bites usually resolve on their own without complications, provided the spider was non-poisonous and proper wound care was carried out to prevent infection. However, it is possible for other deadly signs and symptoms to appear with poisonous spider bites or anaphylaxis. In such cases, the patient should be taken to a hospital immediately.

If bitten by a spider, your doctor may prescribe you drugs to relieve pain and muscle spasms. Antivenom may be given in moderate to severe cases presenting with full-body cramps may be needed. The spider bite wound should be cleaned with betadine (povidone-iodine) solution three times a day and then soaked in sterile salt water (normal saline). Surgical wound repair may be required in more severe cases.

Hospitalization may be required for people younger than 16 or older than 60 and for people with high blood pressure, heart disease or severe symptoms.

In the case of a minor spider bite, an antibiotic ointment like neosporin should be applied daily at the site. Antihistamines should be taken in case of minor skin reactions and itching.