Bites & stings

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Bites stings
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Four Types of Poisonous Snakes in the US
Cottonmouth
Rattlesnake
Copperhead
Coral snake
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Snakebites

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

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Treatment

• ABCs - oxygen prn
• calm patient
• immobilize extremity - splint
• treat shock prn
• draw circle around bite note time
• transport
• if possible safely ID snake

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Notes

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

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Spider Bite

• black widow
• muscle cramps
• abdominal rigidity
• chest tightness dyspnea
• very common spider

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Spider Bite

• brown recluse
• minimal pain
• local tissue reaction
• very rare spider

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Brown Recluse bite
Day 1 Day 2
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Treatment

• ABCs
• reassure patient
• immobilize affected extremities
• treat shock prn
• transport
• no ice
• if possible safely ID spider

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Scorpion sting

• muscle cramps
• excessive salivation
• seizures
• shock
• cardiac arrest

Bark Scorpion
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Treatment

• ABCs - high flow oxygen
• reassure patient
• treat shock prn
• transport
• no ice!
• if possible safely ID scorpion

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Tick Bites

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

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Rocky Mountain Spotted Fever

• develops 7 to 10 days after bite.
• Symptoms
• Nausea, vomiting
• Headache
• Weakness
• Paralysis
• Possible cardiorespiratory collapse

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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

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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

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Marine animals

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

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Treatment

• ABCs - oxygen prn
• treat for shock prn
• limit movement
• scrape off any remaining tentacles
• inactivate with alcohol, meat tenderizer, or
  talcum powder
• no ice

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notes

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

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Bee sting

• local swelling
• pain
• edema

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Treatment

• ABCs
• scrape out stinger
• Monitor and treat for shock prn
• Ice is ok
• transport

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Removing Stingers
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Killer Bees

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

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Review of Allergic Reactions

• Allergic reaction
• Exaggerated immune response to any substance
• Histamines and leukotrienes
• Chemicals released by the immune system

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Five General Allergen Categories

• Insect bites and stings
• Medications
• Plants
• Food
• Chemicals
• Animals

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Anaphylaxis

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

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Urticaria
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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

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Treatment

• ABCs
• high flow oxygen
• administer epi-pen if indicated
• treat for shock prn
• reassure
• rapid transport

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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!

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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.

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Care for Human Bites

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

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stop

• questions?