Bites and Stings

1
Chapter 19

• Bites and Stings

2
Animal Bites

• Dogs are responsible for about 80 of animal bite
  injuries.
• Most are minor.
• Bacteria can enter through bite wound.
• Cat bites have higher rate of infection.
• Ferrets are especially likely to bite.
• Children and older people are at greater risk.

3
Rabies

• Spread through saliva by bite or lick
• Consider rabies if
• Animal attacked without provocation
• Animal was behaving strangely
• High-risk species
• Report animal bites to police or animal control.
• Animal control should capture or confine for
  observation

4
Recognizing an Animal Bite

• Puncture wound
• Tissue/skin crushed
• Open wound on fingers, knuckles, or hand
• Animal present

5
Care for Animal Bites

• Flush with soap and water under pressure.
• Avoid scrubbing.
• Control bleeding and cover wound with sterile
  dressing.
• Seek medical care for cleaning, tetanus shot, or
  rabies care.

6
Human Bites

• After dogs and cats, most likely bit is from
  human.
• Infection can occur.
• Most occur during acts of violence.
• Most common location is hand.

7
Recognizing Human Bites

• Two types
• True bites
• Clenched-in fist injury

8
Care for Human Bites

• Wash with soap and water.
• Avoid scrubbing.
• Flush with running water under pressure.
• Control bleeding with direct pressure.
• Cover with sterile dressing.
• Do not close wound.
• Seek medical care for cleaning, tetanus shot,
  sutures.

9
Snakebites (1 of 2)

• Death from snakebites rarely occurs.
• If death does occur, occurs in first 48 hours.
• Poisonous species in United States
• Rattlesnake
• Water moccasin
• Coral snake
• Copperhead

10
Snakebites (2 of 2)

• Rattlesnake, water moccasin, coral snake are pit
  vipers.
• Triangular, flat heads wider than necks
• Elliptical pupils
• Heat-sensitive pit between eye and nostril on
  each side
• Adult snakebites are more serious.

11
Pit Vipers

• Found in all states but Alaska, Maine, Hawaii
• Most bites are on extremities.
• Alcohol intoxication is a factor.
• Diamondback rattlesnake bites especially deadly.
• Antivenin must be given.

12
Recognizing Pit Viper Bites

• Severe burning pain
• Fang marks
• Swelling
• Discoloration and blood-filled blisters
• Nausea, vomiting, sweating, weakness

13
Care for Pit Viper Bites

• Get victim away from snake.
• Keep victim calm limit movement.
• Wash area with soap and water.
• Stabilize extremity.
• Seek medical care.

14
Coral Snake Bites

• Americas most venomous snake
• Tends to hang on or chew
• Symptoms begin 1 to 5 hours after bite.

15
Recognizing Coral Snake Bites

• Minimal pain
• Sagging or drooping upper eyelids
• Weakness
• Pricking, tingling skin
• Double vision
• Difficulty swallowing
• Sweating
• Abnormal flow of saliva

16
Care for Coral Snake Bites

• Keep victim calm.
• Gently clean with soap and water.
• Apply mild pressure and bandage.
• Seek medical care for antivenin.

17
Nonpoisonous Snake Bites

• Nonvenomous snakes inflict the most bites.
• Some so-called nonpoisonous snakes have venom.
• Can cause painful local reactions.

18
Recognizing Nonpoisonous Snake Bites

• Mild to moderate pinch
• Horseshoe-shaped bite marks
• Bleeding
• Mild itching

19
Care for Nonpoisonous Snake Bites

• Gently clean with soap and water.
• Care same as for minor wound.
• Seek medical care.

20
Insect Stings (1 of 2)

• Some people are allergic.
• Honeybees and some yellow jackets have barbed
  stingers that embed in skin.
• Stingers leave venom, continue to release after
  bee leaves
• Wasp, yellow jacket, hornet, and fire ant
  stingers not barbed.
• Can sting multiple times

21
Insect Stings (2 of 2)

• Mostly self-limited, local reactions
• Swelling/redness might peak 2-3 days after sting.
• Life-threatening symptoms nausea, vomiting,
  wheezing, fever, drippy nose
• Anaphylactic symptoms difficulty speaking,
  tightness in throat/chest, shortness of breath,
  chest pain
• Sting can be fatal in minutes if severely
  allergic.

22
Recognizing Insect Stings

• Pain, redness, itching, swelling
• Worrisome symptoms
• Hives, swelling of lips or tongue, tickle in
  throat, wheezing
• Life-threatening symptoms
• Blue/gray skin color, seizures, unresponsiveness,
  inability to breathe
• Range of symptoms can vary
• Stings to mouth or eye are more dangerous.

23
Care for Insect Stings

• Remove stinger and venom sac.
• Wash with soap and water.
• Apply ice.
• Give aspirin (adults), acetaminophen, or
  ibuprofen.
• Consider topical steroid or antihistamine.
• Observe victim for 30 minutes.
• Assist with prescribed epinephrine kit if
  reaction is severe.
• Call 9-1-1 for signs of severe allergic reaction.

24
Spider and Insect Bites

• Only a few spiders produce significant poisoning.
• Most bites are from female spiders.
• Little immediate pain, difficult to diagnose

25
Black Widow Spiders

• Can also be brown or gray
• Females are large up to 2-inch leg span
• Venom contains neurotoxin
• Causes severe muscle pain, cramping

26
Recognizing Black Widow Spider Bites

• Sharp pinprick, then dull pain
• Two fang marks
• Very severe pain
• Bite on lower body muscle stiffness, abdominal
  cramps
• Bite on upper body muscle stiffness/pain in
  shoulders, back, chest
• Headache, chills, fever, sweating, dizziness,
  nausea, vomiting

27
Care for Black Widow Spider Bites

• Catch spider if possible.
• Clean with soap and water or rubbing alcohol.
• Apply ice.
• Give aspirin (adults), ibuprofen, or
  acetaminophen.
• Monitor breathing.
• Seek medical care.

28
Brown Recluse Spiders

• Violin-shaped figure on back
• Males and females are venomous.

29
Recognizing Brown Recluse Spider Bites

• Local reaction, mild to severe pain at bite site
• Redness, swelling, itching
• Blister forms, becomes red, bursts
• Bulls-eye pattern
• Scab forms, falls off and leaves crater
• Process recurs, leaving larger crater
• Fever, weakness, vomiting, joint pain, rash
• Stomach cramps, nausea, vomiting

30
Care for Brown Recluse Spider Bites

• Catch spider if possible.
• Clean with soap and water or rubbing alcohol.
• Apply ice.
• Give aspirin (adults), ibuprofen, or
  acetaminophen.
• Seek medical care.

31
Tarantulas

• Bite only when provoked or roughly handled
• Will scratch its abdomen with its legs when
  upset.
• Hairs flick onto persons skin
• Bite pain ranges from almost painless to deep
  throbbing pain lasting up to 1 hour.

32
Recognizing Tarantula Bites and Embedded Hairs

• Pain aching or stinging
• Hairs cause itching, inflammation that can last
  several weeks

33
Care for Tarantula Bites and Embedded Hairs (1 of
2)

• Tarantula bite
• Catch spider if possible.
• Clean with soap and water or rubbing alcohol.
• Apply ice.
• Give aspirin (adults), ibuprofen, or
  acetaminophen.
• Seek medical care.

34
Care for Tarantula Bites and Embedded Hairs (2 of
2)

• Embedded tarantula hairs
• Remove hairs with sticky tape.
• Wash with soap and water.
• Apply hydrocortisone cream.
• Give aspirin (adults), ibuprofen, or
  acetaminophen.
• Give antihistamine.

35
Common Aggressive House Spider

• Also called the hobo spider
• Most common large spider in Pacific Northwest

36
Recognizing Common Aggressive House Spider Bites

• Redness, blisters
• Later gangrene (dead tissue)
• Headache, visual problems, weakness

37
Care for Common Aggressive House Spider Bites

• Catch spider if possible.
• Clean with soap and water or rubbing alcohol.
• Apply ice.
• Give aspirin (adults), ibuprofen, or
  acetaminophen.
• Seek medical care.

38
Scorpion Stings

• Look like miniature lobsters
• Bark scorpion is only threat to humans.
• Primarily in Arizona
• Severe cases usually only in children
• Death is rare.
• Ensure airway and breathing.

39
Recognizing Scorpion Stings

• Local immediate pain and burning
• Later, numbness and tingling
• No swelling or blanching
• Tapping finger over site causes pain.
• Can cause paralysis, spasms in legs/arms, facial
  twitching
• Severe reactions fast heart rate, salivation,
  breathing distress

40
Care for Scorpion Stings

• Monitor breathing.
• Gently clean with soap and water or rubbing
  alcohol.
• Apply ice.
• Give aspirin (adults), ibuprofen, or
  acetaminophen.
• Seek medical care.

41
Centipede Bites

• Giant desert centipede is only US centipede
  dangerous to human.
• Can inject venom through fangs (not legs)
• Venom is relatively weak.

42
Recognizing Centipede Bites

• Burning pain
• Local inflammation
• Mild swelling of lymph nodes
• Giant desert centipede bite inflammation,
  swelling, redness lasting 4-12 hours
• Swelling and tenderness can last 3 weeks, or
  disappear and recur

43
Care for Centipede Bites

• Millipedes do not have venom, but can irritate
  skin.
• Wash with soap and water.
• Apply cortisone cream or ointment.
• Centipedes
• Clean with soap and water.
• Apply ice.
• Give aspirin (adults), acetaminophen, or
  ibuprofen.
• Seek medical care for severe reactions.

44
Mosquito Bites

• Mosquitoes can carry malaria, yellow fever,
  dengue fever, encephalitis.
• No evidence of transmitting HIV or AIDS
• Need blood to lay eggs
• Breed in water
• Most bite at twilight

45
Care for Mosquito Bites

• Wash with soap and water.
• Apply ice.
• Apply calamine lotion or hydrocortisone ointment.
• Victims with many bites or allergic reaction may
  take antihistamine or physician-prescribed
  cortisone.

46
Embedded Ticks

• Hard ticks familiar from domestic animals
• Soft ticks mainly in western states
• Can carry diseases
• Need blood meal to grow to next stage
• Bites are nearly painless
• Burrows head in skin
• As they feed, their body size increases.

47
Care for Embedded Ticks(1 of 2)

• Remove with tweezers as soon as possible.
• Grasp as close to skin as possible.
• Lift with enough force to tent skin.
• Hold until tick lets go (1 minute).
• Pull tick away from skin.

48
Care for Embedded Ticks(2 of 2)

• Wash with soap and water.
• Apply rubbing alcohol.
• Apply ice.
• Apply calamine lotion.
• Watch bite site for rash for one month.
• Seek medical care for rash.
• Watch for fever, muscle aches, sensitivity to
  bright light, leg weakness, paralysis

49
Fire Ants

• Aggressive, can sting repeatedly
• Immediate pain
• Red, swollen area which disappears in 45 minutes
• Blister forms, ruptures in 30-70 hours, can
  become infected
• Anaphylaxis can occur.
• Apply ice.
• Use topical corticosteroid cream.

50
Marine Animal Injuries

• Most sting in defense, not attack
• Can cause anaphylaxis
• If serious reaction, keep airway open.

51
Sharks

• Very minimal chance of attack
• Leg is most frequently bitten part
• Injuries are similar to boat propeller injuries
  or chainsaw injuries.
• Immediate bleeding control and shock treatment
  are essential.

52
Recognizing a Shark Bite

• Severe bleeding
• Large, open wounds, most often on legs
• Abrasions from contact with sharkskin

53
Care for a Shark Bite or Puncture

• Control bleeding.
• Treat for shock.
• Seek medical care.

54
Barracudas and Moray Eels

• Barracuda bites are rare.
• Moray eels can give multiple puncture wounds.
• Have high infection risk
• First aid for both is identical as for shark bite.

55
Recognizing Barracuda and Moray Eel Bites

• Barracuda lacerations
• Similar to shark lacerations
• Eel bites
• Severe puncture wounds
• Hold on to victim
• Leave multiple, small puncture wounds

56
Care for Barracuda and Moray Eel Bites

• Barracuda bite
• Same care as shark bite
• Eel bite
• Flush wound with water under pressure.
• Control bleeding.

57
Marine Animals That Sting

• Important to identify specific animal
• Reactions include mild dermatitis to severe
  reactions.
• Portuguese man-of-war sting well-defined linear
  welts
• Jellyfish sting severe muscle cramping, thin
  lines of welts in zigzag pattern
• Anemones also sting.

58
Recognizing Marine Animal Injuries

• Stinging
• Severe itching, burning
• Prickling, tingling
• Blisters
• Severe allergic reaction
• Difficulty breathing
• Muscle cramping
• Nausea, vomiting

59
Care for Marine Stings

• Apply vinegar or alcohol.
• Scrape off tentacles.
• Reapply vinegar or alcohol, soaking for 15
  minutes.
• Monitor breathing.

60
Stingrays

• Usually peaceful, lie buried in sand or mud
• Wounds occur when victim steps on ray.
• Barbed tail thrusts into victims leg or foot
• Usually like a laceration
• Venom causes intense burning pain.

61
Recognizing a Stingray Puncture

• Sudden, intense pain
• Open wound
• Swelling

62
Care for a Stingray Puncture

• Immerse injured part in hot water for 30-90
  minutes.
• Wash with soap and water.
• Irrigate with water under pressure.
• Treat like any puncture wound.