SITUATION: You’re dozing in your tent during an overnight at a popular campground when you become aware of a pinching sensation on your arm. You assume it’s nothing more than a hungry mosquito — until someone in your tent announces that they’ve discovered a poisonous brown recluse spider. Suddenly you feel feverish and develop chills and cold sweats. Is it venom setting in … or just panic? Do you have a venomous spider bite?
Solution: The majority of spiders found in the U.S. are venomous. But that’s somewhat misleading, because most deliver only enough venom to harm, ahem, a fly.
Some species, however — like the brown recluse — can be dangerous and even deadly to humans. “Of all of the known spiders, only a few have venom potent enough to cause symptoms in humans,” says Dr. 
Seth Haplea, a neurologist. “In the U.S., only the female black widow spider can cause serious neurological dysfunction.”
In dealing with suspected venomous spider bites, it is important to mention a few caveats: Many insects bite; many people develop adverse reactions to any insect bite; identifying a spider bite is notoriously difficult; and, generally, spiders are not aggressive.
It’s also important to note that you should not expect to see the two telltale spider “fang” marks on the wound site. If you suspect a spider has bitten you and a venomous species has been spotted nearby, the first step is to secure the spider or at least snap a picture of it (you can post it on Instagram later). An emergency room physician will be greatly assisted if the spider in question can be identified.
Depending on the size of the spider, the size of the victim and the location of the bite, symptoms might take hours or days to become apparent. This usually includes pain at the bite site and initial swelling. Additional symptoms (depending on the type of spider) might include large welts, swelling in glands and lymph nodes, headache, fever, nausea and respiratory trouble — and, in the case of a serious black widow bite, paralysis.
If you’ve been bitten on an extremity, lower it to a level below the heart to reduce the spread of venom. Use an ice pack wrapped in a cloth to reduce swelling, as well as topical antihistamine, if available.
A bite from one of the venomous species noted above should be considered a medical emergency that demands a trip to the emergency room. Do you need to be medevaced? No, unless you’re days from a hospital. Field dress the wound, hike out and drive to the ER.
Josh Piven is the co-author of The Worst-Case Scenario Survival Handbook series. Visit joshuapiven.com.
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But first, DON’T PANIC.
I find keeping some ammonia with me helps as well. Ammonia can help neutralize insect bites especially if applied right after the bite. It will burn a little but I find it to be most helpful. Follow that with some salt (which burns a lot) can also help if you are going to have a hard time keeping the bite clean or if it starts showing signs of infection before you can get it treated.
Why would you reduce swelling in this case? The swelling is the body’s way of applying direct pressure. Without the swelling, blood flow is increased: exactly what you don’t want. For most insect bites, sure – get the swelling down to reduce itching and further compounding risk of introducing bacteria. But a suspected dangerous venomous bite? I’m not convinced.
I was bit by a black widow on the hand. Ice pack, antihistimine, antibiotic with pain, and a Tylenol for the pain. I screamed, terrible crying pain for a few hours, muscle spasm in different part of the body for two days, then an er visit to make sure not worsening. Bite became infected and I needed antibiotic. I saw the female black widow, but try to trap the spider to take with you to er if you cannot identfy it.
I was just bitten several times last weekend by a brown widow. One bite had redness and swelling to an almost 8″ diameter. I tried a topical antihistamine and it did nothing. I ended up applying a compress with epsom salt salt and lavender and tea tree oils to draw out the poison and disinfect the bite. All bites are healed up and I am going to keep epsom salt in my first aid kit from now on.
good to know