1. (Other Medical Topics)
Bites and Stings
(Other Medical Topics)

2. If you cannot cope alone, get help or call 995 for ambulance.
Introduction
Most animals and insects do not usually attack unless injured or otherwise provoked, and common sense can prevent many bites and stings.
You must always take sensible precautions before attempting, for example, to rescue a casualty from an angry dog or a swarm of bees.
If you cannot cope alone, get help or call 995 for ambulance.

3. Scope First-Aid Priorities Animal Bites Insect Stings
Injuries by Marine Creatures
Snake Bites
Q & A

4. First-Aid Priorities
Make sure that you are in no danger, then remove the casualty from further danger
Treat any visible wound or painful symptoms, and minimise the risk of further injury and infection.
Obtain medical attention if necessary.
Note the time and nature of the injury, and identify the attacking creature if possible. This enables medical personnel to deal with the injury itself and to anticipate possible complications, such as anaphylactic shock.

5. Animal Bites
Bites from sharp, pointed teeth cause deep puncture wounds that can carry germs far into the tissues.
Human bites also crush the tissues. Hitting someone’s teeth with bare fist can produce a “bite” wound at the knuckles.
Any bite that breaks the skin cause a wound very vulnerable to infection; it needs prompt first aid and medical attention.

6. Treatment for Animal Bites (For serious wounds)
Control bleeding by applying direct pressure and raising the injured part.

7. Treatment for Animal Bites (For serious wounds)
Cover the wound with a sterile dressing or a clean pad bandaged in place.
Arrange to take or send the casualty to hospital.

8. Treatment for Animal Bites (For superficial wounds)
Wash the wound thoroughly with soap and warm water.

9. Treatment for Animal Bites (For superficial wounds)
Pat the wound dry with clean gauze swabs and cover with an adhesive dressing or small sterile dressing.
Advise the casualty to see a doctor in case inoculation is needed.

10. Potential Infections of Animal Bites
Rabies
A potentially fatal viral infection of the nervous system, spread in the saliva of infected animals.
Hepatitis B or C viruses
There is probably only a small risk of hepatitis B or C viruses being transmitted through a human bite.

11. Safety Precautions Against Animal Bites
Do not throw objects or provoke animals (Dogs etc…)
Do not intrude their territory

12. Insect Stings
Bee, wasp and hornet stings usually are painful rather than dangerous.
An initial sharp pain is followed by mild swelling and soreness, which first aid can relieve.
Some people are allergic to stings and can rapidly develop the serious condition of anaphylactic shock. Multiple stings can also be dangerous.
Stings in the mouth or throat are serious, as swelling can cause obstruction to the airway.

13. Symptoms of Bee Stings Red, swollen, or warm lump Hives Rash
Itching, tingling, numbness, burning, tenderness, pain
Serious allergic reactions (anaphylaxis) occur when symptoms spread. These can include difficulty in breathing, dizziness, nausea, diarrhea, fever, muscle spasms, or loss of consciousness. Call for emergency medical help right away.

14. Treatment for Insect Stings (For a sting in the skin)
If the sting is still in the wound, pluck it out firmly with fine tweezers.
If stung on the fingers or hands, remove any rings and watches in case of swelling.
Wrap a few ice cubes in a towel and apply on the area for minutes to stop the pain and swelling. Do not apply ice directly on the sting area to prevent frostbite. Advise the casualty to see his doctor if the pain and swelling persist.

15. Treatment for Insect Stings (For a sting in the mouth)
Give the casualty ice to suck or cold water to sip, to minimise swelling. DIAL 995 FOR AN AMBULANCE. Reassure the casualty.

16. Treatment for Insect Stings (For Tick Bites)
Using fine-pointed tweezers, grasp the tick’s head as close to the casualty’s skin as possible.
Use a slight to-and-fro action to lever, rather than pull, the head out. The mouthparts will be very firmly embedded in the skin; try to avoid breaking the tick and leaving the buried head behind.

17. Treatment for Insect Stings (For Tick Bites)

18. Safety Precautions Against Insect Bites/Stings
Use insect repellants
Wear long pants / T-shirt
During an attack, cover your face and run in a straight line as quickly as possible.
Grab a net, coat, towel, or anything that will give you momentary relief.
During your escape, try to find shelter like a house, tent or car with windows and door closed.
Avoid other people as they too may come under attack.
Bees may pursue for up to 400m
They are slow fliers and most people can outrun a bee.
Hence, be alert for bees coming in and out through cracks in a wall.
Stay away once you notice a bee colony. Do not provoke it.

19. Injuries by Marine Creatures
Sea creatures can cause injury in various ways.
In some parts of the world, particularly in tropical regions, severe poisoning can occur, and occasionally death results from a severe allergic reaction (anaphylactic shock), or paralysis of the chest muscles leads to drowning.

20. Dangerous Sea Creatures
Jellyfish
Jellyfish stings occur when people brush against it in the water or step on those washed ashore. Jellyfish washed ashore can sting for weeks. Detached tentacles can also release venom.
The Portuguese Man-of-War is well known for its painful and powerful sting. The stings can cause fever, shock as well as heart and lung problems.                Sea wasps (Box Jellyfish) have tentacles containing thousands of stinging cells. Stings usually occur when people bump into them. The tentacles become sticky and adhere tightly to the skin. When the cells come into contact with human skin, they release their venom and cause severe pain.

21. Dangerous Sea Creatures
Sea urchins
Sea urchins are found in tropical and subtropical marine regions. The spines of the sea urchins are used to deliver their venom. The sting can cause severe burning pain, swelling, bleeding, itch, nausea, vomiting, muscle weakness and difficulty breathing. The symptoms may develop immediately and may last up to 6 hours. Deep puncture wounds may be seen after a sting.
Stingrays
Stingrays are often found buried and feeding in shallow water. Stingrays are not aggressive by nature. People are usually stung when they step on the stingray. The sting causes profuse bleeding, swelling and severe pain that can last for months. Other symptoms that may develop are nausea, vomiting, diarrhoea, sweating, muscle cramps, and fits.
Blue-ringed Octopus
This is a very small octopus found in shallow tropical water and in tide pools. It is normally yellowish-brown but changes its rings to a bright blue when disturbed. The sting is usually painless but there may be symptoms of numbness, which may lead to paralysis and respiratory failure. 

22. Dangerous Sea Creatures
Lionfish
Lionfish are brightly coloured fish and are usually found in coral reefs. They are also kept as pets in home aquariums. Lionfish have venomous fin spines that can produce painful puncture wounds. Their stings can also cause nausea, breathing difficulties, paralysis, fits and collapse. 
Scorpionfish
Scorpionfish live in shallow water. The skin resembles algae or sponges and is often mottled, with patches of red or blue. This makes them difficult to tell them apart from rocks and seaweed. Scorpionfish have spines with venomous glands. Their stings can cause severe pain.
Stonefish
Stonefish may be round from exposed sand and mud. It looks exactly like encrusted rock and feeds on small fish and shrimps. It has a row of 13 venomous spines along its back. People are usually stung when they step on or catch a stonefish. The sting can cause severe pain, swelling, muscle weakness, numbness and shock.

23. Dangerous Sea Creatures
Catfish
Stings occur when these slimy-skinned fish are handled. The sting can cause pain and swelling.
Cone shells
Cone shells are marine snails found in reefs. They produce venom that may lead to symptoms of pain, swelling and numbness.  Weakness, lack of coordination, nausea, itch and respiratory distress may also result.
Sea cucumbers
Sea cucumbers have an elongated body. Tentacles encircle the mouth. They live in temperate, subtropical and tropical waters. Contact with sea cucumbers can result in a rash and severe eye irritation. Blindness may occur if brought into contact with the eyes.

24. Treatment for Marine Stings
Reassure the casualty and sit him or her down, Pour copious amounts of vinegar or sea water over the injury to incapacitate stinging cells that have not yet released venom.
*Alcohol may aggravate the injury and should not be used. Avoid rubbing sand on the affected area.

25. Treatment for Marine Stings

26. Treatment for Marine Stings
Dust a dry powder over the skin around the affected area to make any remaining stinging cells stick together. Talcum powder is very good for this. Meat tenderiser, used in barbecue cooking, is also good as it contains papain, which inactivates venom.

27. Treatment for Marine Stings

28. Treatment for Marine Stings
Gently brush off the powder with a clean, non-fluffy pad.
If the injuries are severe, or there is a serious general reaction, DIAL 995 FOR AN AMBULANCE.
If the casualty is having difficulty breathing, she may be in anaphylactic shock.

29. Treatment for Marine Puncture Wounds
Gently pull out any protruding spines. Do not crush the spines.
Soak the affected area into hot (not scalding) water for minutes to ease pain. If pain returns later, try the heat soaks again.
Take or send the casualty to hospital.

30. Safety Precautions against stings from Marine Creatures
Proper footwear
Be careful when handling catfish / stonefish / stingray as they have venomous spines
Keep away from jellyfish

31. Snake Bites
Black Spitting Cobra

32. Snake Bites
A snake bite is often not a serious injury, but it can be very frightening. Snake bites that may result in serious injury include those from the cobra and blue coral snake.
Reassurance is vital, for if the casualty keeps still and calm, the spread of venom may be delayed.
Try to get a description of the snake. This will help the doctor to identify the snake and the correct treatment. Do not try to catch the snake.
Notify the police if the snake remains at large.

33. How to Recognise a Snake Bite
A pair of puncture marks.
Severe pain at the site of the bite.
Redness and swelling around the bite.
Nausea and vomiting.
Laboured breathing; in extreme cases, respiration may stop altogether.
Disturbed vision.
Increased salivation and sweating.

34. Treatment for Snake Bites
Stay calm. Not all snakes are poisonous.
Lay the casualty down. Tell her to keep calm and still.
Wash the bite site with soap and water DIAL 995 FOR AN AMBULANCE.

35. Treatment for Snake Bites
If there is eye irritation, rinse the eye under gently running cool water for at least 15 minutes. Prevent run-off water from entering the unaffected eye.
Immobilise the bitten limb, using a splint if possible and position it below the level of the heart If she stops breathing, be ready to resuscitate if needed.
*DO NOT apply a tourniquet, a bandage or ice on the wound, slash the wound with a knife, or suck the venom.
Blue Coral Snake

36. Treatment for Snake Bites

37. Safety Precautions from Snake Bites
Do not try and chase, provoke, catch or beat up the snake
Move away if you spot a snake

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Conclusion