Wilderness Medicine, First Aid, and Outdoor Skills
Black Widow Spider - Black Widow Bites Treatment

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US Army First Aid Manual
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Appendix A: First Aid Case and Kits, Dressings, and Bandages
Appendix B: Rescue and Transportation Procedures
Appendix C: Common Problems/Conditions
Appendix D: Digital Pressure
Appendix E: Decontamination Procedures
Appendix F: Glossary

Black Widow Spider

Females are 1-2" in diameter
Males much smaller

The female black widow is shiny black with a red hourglass on abdomen; however this does not always have to be the case. The red hourglass could take the form of a red dot or many variations of shapes.

The black widow is common in fields, woodpiles, and unoccupied dwellings. Black widows are found in every state except Alaska.

Mature Black Widow

Black Widow Closeup

Venom

Black widow venom is primarily a neurotoxin, which as a rule does not cause local tissue death and destruction. Best known for widespread muscle spasm and often mimics that of a severe abdominal problem i.e. acute appendicitis, or ruptured ovarian cyst.

The initial bite is very painful, but can go unnoticed. The

surface of the skin may display two red bite wounds, one, or none. The worst pain is in the first 8-12 hours, symptoms may continue for several days.

All children, pregnant women and individuals with hypertension should be admitted to a hospital.

Antivenom is available.

Outdoor treatment for Black Widow bites:

  • Clean and irrigate the wound.
  • Application of ice or cool compresses.
  • Pain medication, muscle relaxants if available.
  • Transport immediately.

Mature Black Widow Above
Photos by Wayne Talley, North of Dallas, TX

Immature Black Widow Below
Captured by Launa McCray, R.N.
Photos by Dan Williams Psy. D., PA-C

Immature Black Widow Black Widow Next to Penny

Black widow bite symptoms
Initially, almost all bites from the latrodectus species is felt as an immediate pinprick sensation, and local pain. In approximately one hour after the bite, a small, erythematous area develops. This becomes larger with a blanched center. The venom acts through a calcium-mediated mechanism, which is the release of acetylcholine and nor-epinephrine. Subsequently , the vast majority of patients, around 70%, do experience hypertension, nausea, light sensitivity to the eyes, which is called photophobia, difficulty breathing, diarrhea, and muscle spasms and aches. These individuals can present like an acute abdomen, and mimic a ruptured ovarian cyst or appendicitis. In one study in Australia, however, around 70% of the individuals only presented with local symptoms and did not present with systemic symptoms.

Treatment
Intravenous narcotics for pain, and the benzodiazepines help tremendously. In the past, calcium gluconate infusion was thought to be helpful. However, it is not recommended any longer. Anti-venom against the latrodectus species is available by Merck and Company. Advise only to use in severe cases. You need to weigh using the anti-venom vs. the presentation of the patient. It is also important to dilute the anti-venom. Please see Merck and Company handout with the latrodectus anti-venom for dilution.




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