Bites & stings

1. Bites & stings

2. Four Types of Poisonous Snakes in the US Cottonmouth Rattlesnake Copperhead Coral snake

3. Snakebites Symptoms • puncture wounds • swelling • pain • weakness • metallic taste (some types)

4. Treatment • ABC’s - oxygen prn • calm patient • immobilize extremity - splint • treat shock prn • draw circle around bite & note time • transport if possible safely ID snake

5. Notes • NO ICE • NO INCISIONS (no cut & suck) • No Constricting Band California regulations include the use of a constricting band proximal to bite.

6. Spider Bite • black widow • muscle cramps • abdominal rigidity • chest tightness & dyspnea • very common spider

7. Spider Bite • brown recluse • minimal pain • local tissue reaction • very rare spider

8. Brown Recluse bite Day 1 Day 2

9. Treatment • ABC’s • reassure patient • immobilize affected extremities • treat shock prn • transport no ice if possible safely ID spider

10. Scorpion sting • muscle cramps • excessive salivation • seizures • shock • cardiac arrest Bark Scorpion

11. Treatment • ABC’s - high flow oxygen • reassure patient • treat shock prn • transport no ice! if possible safely ID scorpion

12. Tick Bites • Ticks attach themselves to the skin • not painful • commonly carry Rocky Mountain spotted fever or Lyme disease.

13. Rocky Mountain Spotted Fever • develops 7 to 10 days after bite. • Symptoms • Nausea, vomiting • Headache • Weakness • Paralysis • Possible cardiorespiratory collapse

14. Lyme Disease • The second fastest growing infectious disease next to AIDS in US • symptoms may begin 3 days after the bite. • Symptoms include: • Rash • Painful swelling of the joints

15. Treatment • No hurry in removing tick • Use tweezers and pull tick straight out • Take tick with you for ID • Treat S/S prn • Position of comfort • Transport

16. Marine animals Coelenterates- Jellyfish, sea anemone, some corals • Nematocysts – stinging cells • local reaction at site – painful, red lesions • Rarely - shock (from anaphylaxis)

17. Treatment • ABC’s - oxygen prn • treat for shock prn • limit movement • scrape off any remaining tentacles • inactivate with alcohol, meat tenderizer, or talcum powder no ice

18. notes Sting Ray sting • treat by soaking in warm water. • Do not attempt to remove barb.

19. Bee sting • local swelling • pain • edema

20. Treatment • ABC’s • scrape out stinger • Monitor and treat for shock prn • Ice is ok • transport

21. Removing Stingers

22. “Killer Bees” • Africanized Honey Bees (AHB) • looks identical • very aggressive • chase up to 1/4 mile • contact police or fire department

23. Review of Allergic Reactions • Allergic reaction • Exaggerated immune response to any substance • Histamines and leukotrienes • Chemicals released by the immune system

24. Five General Allergen Categories • Insect bites and stings • Medications • Plants • Food • Chemicals • Animals

25. Anaphylaxis • Severe allergic reaction • Dyspnea, wheezing, stridor • Urticaria (hives) • flushed skin • shock • respiratory arrest

26. Urticaria

27. Anaphylactic Reactions to Stings • 5% of all people are allergic to bee, hornet, yellow jacket, and wasp stings. • ~ 200 deaths a year. • Most deaths occur within first half hour

28. Treatment • ABC’s • high flow oxygen • administer epi-pen if indicated • treat for shock prn • reassure • rapid transport

29. Dog Bites • Potentially infected wounds • May require antibiotics, tetanus, suturing • Apply dry sterile dressing and transport promptly • Rabies = major concern *Remember scene safety is top priority!

30. Dog Bites and Rabies (2 of 2) • Rabies- an acute viral infection to the central nervous system • Can only be treated with a series of vaccine injections. • A bitten patient can avoid shots only if the dog can be identified and tested for rabies.

31. Care for Human Bites • human bites that penetrate the skin can be serious injuries. • immobilize the area • Apply a dry, sterile dressing • Transport

32. stop questions?