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 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 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 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 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 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 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) 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 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 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 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) 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 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 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.