Transcript Document 7164959

Chapter 19
Bites and Stings
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.
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
Recognizing an Animal Bite
• Puncture wound
• Tissue/skin crushed
• Open wound on
fingers, knuckles, or
hand
• Animal present
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.
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.
Recognizing Human Bites
• Two types:
• True bites
• Clenched-in fist injury
Care for Human Bites
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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.
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
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.
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.
Recognizing Pit Viper Bites
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Severe burning pain
Fang marks
Swelling
Discoloration and
blood-filled blisters
• Nausea, vomiting,
sweating, weakness
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.
Coral Snake Bites
• America’s most venomous
snake
• Tends to hang on or chew
• Symptoms begin 1 to 5 hours
after bite.
Recognizing Coral Snake Bites
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Minimal pain
Sagging or drooping upper eyelids
Weakness
Pricking, tingling skin
Double vision
Difficulty swallowing
Sweating
Abnormal flow of saliva
Care for Coral Snake Bites
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Keep victim calm.
Gently clean with soap and water.
Apply mild pressure and bandage.
Seek medical care for antivenin.
Nonpoisonous Snake Bites
• Nonvenomous snakes inflict the
most bites.
• Some so-called nonpoisonous
snakes have venom.
• Can cause painful local reactions.
Recognizing Nonpoisonous
Snake Bites
• Mild to moderate pinch
• Horseshoe-shaped bite
marks
• Bleeding
• Mild itching
Care for Nonpoisonous Snake
Bites
• Gently clean with soap and
water.
• Care same as for minor
wound.
• Seek medical care.
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
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.
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.
Care for Insect Stings
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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.
Spider and Insect Bites
• Only a few spiders produce
significant poisoning.
• Most bites are from female
spiders.
• Little immediate pain, difficult to
diagnose
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
Recognizing Black Widow
Spider Bites
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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
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.
Brown Recluse Spiders
• Violin-shaped
figure on back
• Males and females
are venomous.
Recognizing Brown Recluse
Spider Bites
• Local reaction, mild to severe pain at bite site
• Redness, swelling, itching
• Blister forms, becomes red, bursts
• Bull’s-eye pattern
• Scab forms, falls off and leaves crater
• Process recurs, leaving larger crater
• Fever, weakness, vomiting, joint pain, rash
• Stomach cramps, nausea, vomiting
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.
Tarantulas
• Bite only when provoked or roughly
handled
• Will scratch its abdomen with its legs
when upset.
• Hairs flick onto person’s skin
• Bite pain ranges from almost painless
to deep throbbing pain lasting up to 1
hour.
Recognizing Tarantula Bites
and Embedded Hairs
• Pain — aching or
stinging
• Hairs cause itching,
inflammation that can
last several weeks
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.
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.
Common Aggressive House
Spider
• Also called the hobo spider
• Most common large spider in
Pacific Northwest
Recognizing Common
Aggressive House Spider
Bites
• Redness, blisters
• Later: gangrene (dead tissue)
• Headache, visual problems,
weakness
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.
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.
Recognizing Scorpion Stings
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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
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.
Centipede Bites
• Giant desert centipede is only US
centipede dangerous to human.
• Can inject venom through fangs
(not legs)
• Venom is relatively weak.
Recognizing Centipede Bites
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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
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.
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
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.
Embedded Ticks
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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.
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.
Care for Embedded Ticks
(2 of 2)
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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
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.
Marine Animal Injuries
• Most sting in defense, not attack
• Can cause anaphylaxis
• If serious reaction, keep airway
open.
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.
Recognizing a Shark Bite
• Severe bleeding
• Large, open
wounds, most often
on legs
• Abrasions from
contact with
sharkskin
Care for a Shark Bite or
Puncture
• Control bleeding.
• Treat for shock.
• Seek medical care.
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.
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
Care for Barracuda and Moray
Eel Bites
• Barracuda bite
• Same care as shark bite
• Eel bite
• Flush wound with water under pressure.
• Control bleeding.
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.
Recognizing Marine Animal
Injuries
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Stinging
Severe itching, burning
Prickling, tingling
Blisters
Severe allergic reaction
Difficulty breathing
Muscle cramping
Nausea, vomiting
Care for Marine Stings
• Apply vinegar or alcohol.
• Scrape off tentacles.
• Reapply vinegar or alcohol,
soaking for 15 minutes.
• Monitor breathing.
Stingrays
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Usually peaceful, lie buried in sand or mud
Wounds occur when victim steps on ray.
Barbed tail thrusts into victim’s leg or foot
Usually like a laceration
Venom causes intense burning pain.
Recognizing a Stingray
Puncture
• Sudden, intense pain
• Open wound
• Swelling
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.