Bites Stings And Poison

Bites, Stings and Poisons

Don’t do more harm

Bites And Stings 

Rinse all bites 5 minutes with water 

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(except severe bites)

Clean with soap and water

Domestic pets

Domestic pets  

Cats and dogs. Why important? Rabbies – wound- tetanus

What first aid you may give? If you or your child is bitten by an animal, follow these guidelines: 1-If the bite barely breaks the skin, treat it as a minor wound. Wash the wound thoroughly with soap and water. Apply an antibiotic cream to prevent infection and cover it with a clean bandage. 2-If the bite creates a deep puncture of the skin or the skin is badly torn and bleeding, apply pressure to stop the bleeding and see your doctor.

. When ?

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* If you notice signs of infection such as swelling, redness, increased pain or oozing, see your doctor immediately. * If you suspect the bite was caused by an animal that might harbor rabies — any unprovoked bite from a wild or domestic animal of unknown immunization status — see your doctor immediately. Doctors recommend you get a tetanus shot every 10 years. If your last one was more than 5 years ago and your wound is deep or dirty, your doctor may recommend a booster. You should have the booster within 48 hours of the injury.

Dog Bites 

If approached:      

Stop/ Stand still Talk softly Move slowly Never turn your back on a dog Use: stick, mace, pepper spray Concern for rabies

Rabies: Be Concerned If Skin Is Penetrated By:   

Unprovoked animal (squirrel) Strange acting dog or other animal Animal of high risk species 

Raccoons

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Bats

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Foxes Skunks

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Bites and Rabies 

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An acute virus disease of the nervous system of warm-blooded animals, usually transmitted through the bite of a rabied animal Results in hydrophobia: throat muscles go into spasm if they try to drink and they choke

No cure once symptoms develop

Rabies: What To Do 

If bitten by a wild animal - suspect rabies  

Clean wound with soap and water (under pressure) Seek medical attention  Tetanus shot may be required  Start rabies treatment immediately (5 arm injections over one month)

Rabies: What To Do With The Animal 

Kill animal and transport entire body to a vet 

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Wear gloves to avoid infected saliva Vet will decapitate and submit the head for rabies testing

Snake bite How it will look like?

Snake bite

Grades of envenomation,symptoms and signs within 2 to 5 hours 

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Minimal- moderate pain, edema 2.5-15 cm, erythema, no systemic symptoms Moderate- severe pain, tenderness, edema 25-40 cm, erythema, petechiae, vomiting, fever, weakness Severe-Widespread pain, tenderness, edema 40-50 cm, ecchymosis, systemic signs, vertigo, rapid swelling, CNS symptoms, visual disturbance, shock, convulsions

If severe  Antivenom If moderate  Antivenom If minimal  nothing Many are “dry” bites

Snake bite first aid Assure the victim to keep him calm.  Avoid unnecessary movement of the affected limb.  Bandages around the affected limb. + Immobilization. 

Snake bite first aid pressure-immobilization

pressure-immobilization

pressure-immobilization

Snakebites 

Poisonous snakes in the U.S. Rattlesnake  Copperhead  Water moccasin  Coral snake  Philippines Philippine cobra Philippine python 

Pit Vipers   

Rattlesnake Copperhead Water moccasin 

Characteristics: Flat heads that are wider than their necks (triangular)  “Cat eyes” (elliptical)  Heat sensitive “pit” between the eye and nostril on each side of the head 

Pit Viper Bites: Signs and Symptoms  

Severe burning/ fang marks Swelling (occurs in 5 minutes and can involve entire extremity 

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Mark extent of swelling on body

6-10 hours later: potential discoloration and blood filled blisters

Coral Snake Bites  

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Most venomous, but rarely bites Red, yellow and black bands 

Every other band is yellow

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Red on yellow, kill a fellow. Red on black, venom lack.

Injects venom into the body

Snake Bites: What To Do (controversial but generally recommended) 

Pit Viper 

Get away from snake / may re-strike  

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Can strike ½ the length of their body A decapitated head can react for 20 more minutes

Have victim lie down and stay calm Do not move victim unless absolutely necessary Keep bitten area immobile and below the level of the heart Call 911 Wash area with soap and water

Snake Bites: What To Do #2 

If more than 1 hour from medical facility, use “extractor” within 3 minutes and left on for 30 minutes (pit vipers only)  (up

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to 30% of venom may be removed)

Seek medical attention immediately  Anti-venom

available only at hospitals  Same anti-venom used no matter type of snake  Must be given within 4 hours of the bite

Snake Bites: What To Do 

Do Not’s     

Icing is not helpful “Cut and suck method” mouth suction constriction bands (bite on local woman)

Coral Snake Bites: What To Do 

Coral Snake 

Use same methods except:  Do

not use “extractor”  Apply mild pressure over the bite site and wrap entire limb with an ace bandage  No ice is necessary

Non-Poisonous Bites  

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Horseshoe shaped tooth marks May be painful but no systemic reactions What To Do?  

Minor wound treatment If in doubt, go to hospital or call Dr.

Snake Bite Prevention       

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Use caution around wood piles, rock crevices etc. Watch where you step Do not reach into holes or hidden ledges Wear boots, long pants, long sleeved shirts Don’t sit or step over logs without checking it out Use a walking stick When camping, keep tent zipped at all times (float trip)(child sat on snake) Take a friend along

Snakes: Additional Information  

Baby snakes have stronger venom Snakes just out of hibernation have stronger venom

Spider Bites   

Tarantula Black Widow Brown Recluse

Tarantula 

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Not life threatening Treatment  

Cortisone cream Antihistamines (benadryl)

Black Widow Bites 

Bite:   

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Pin-prick or no “bite” sensation Immediate pain, swelling, redness Headache, chills, fever, heavy sweating, dizziness, nausea, vomiting, severe abdominal pain Faint red bite marks appear Severe muscle pain, cramps, and stiffness

Severe pain peaks in 2-3 hours but can last up to 48 hours

Brown Recluse    

Found in dark, dry places Violin shapes on backs Slight initial pain Severe pain in 2 to 8 to 12 hours

Brown Recluse 

Redness, swelling, itching  

Volcano lesions result Possible consequences:  Skin

grafting  gangrene

Spider Bites: What To Do      

Save spider for identification Keep bite area below the heart Clean bite site Ice Monitor ABC,s Seek medical attention immediately

Ticks Rocky Mountain Spotted Fever  Colorado Tick Fever  Lyme Disease 

Lyme Disease 

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Spread by animals that carry deer ticks:  White tailed deer/ White footed mice  found primarily in the Northeastern U.S. Signs and symptoms: 3 to 30 days post bite Is difficult to diagnose: Flu-like, fever, chills, headache, joint stiffness, fatigue May be diagnosed initially as arthritis May come and go for years Rash: white center with redness all around (hot to touch but without pain) Treat with proper antibiotics

Prevention for Tick Bites      

Insect repellent (DEET) Check for ticks frequently and remove Stay on path when hiking Tape jeans to boots Wear long sleeved shirts, long pants 7 dust for yards (controls fleas as well)

Tick Removal 

Check hairy parts of the body (student)

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Remove as soon as possible with tweezers (pull slowly and gently)  

Do not use nail polish, hot match etc. If head or mouthparts remain, remove as if a splinter

Tick Bites: First Aid   

Clean wound site Watch for infection and other symptoms See physician if:  Rash  Fever, muscle aches, sensitivity to bright light, weakness in limb, paralysis

Human bites 1.

Why ? Dangerous. How? What first aid? If you sustain a human bite that breaks the skin: Stop the bleeding by applying pressure.

2.

Wash the wound thoroughly with soap and water.

3.

Apply an antibiotic cream to prevent infection.

4.

Apply a clean bandage.

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Insect Stings 

Worrisome Reactions:  Normally, the sooner the symptoms develop, the more serious       

Flushed skin /blue skin Hives Swelling of lips, tongue, throat Wheezing, “tickle in throat” Abdominal cramps, diarrhea Trouble breathing Seizures

Africanized honeybees 

Known as killer bees

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Now found in Texas, Arizona, California, and most of the temperate southeastern and southwestern states.

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Attack from these bees  massive stinging resulting in multisystem damage and death from severe venom toxicity.

Stings: First Aid 

Remove stinger by scraping with a credit card or like item (back out the stinger) 

Stinger injects poison for 2-3 minutes up to 20 minutes after sting

Stings: First Aid #2 

Cleanse site    

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Use extractor if available Use a commercial “sting stick” Apply ice (slows absorption, relieves pain) Vinegar or lemon juice suggested for wasp sting

hydrocortisone cream Benedryl (or other antihistamine) if given early may prove helpful

Stings: First Aid #3 

Observe for 30 minutes   

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Keep anaphylaxis in mind Epinephrine Re-inject after 15 minutes if necessary

Watch for delayed allergic reaction (possibly the next day)

Hymenoptera Venom: Treatment

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Immediate removal of the bee stinger from the wound, is the important principle rather than the method of removal.

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Wash the sting site with soap and water to decrease risk of infection.

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Oral antihistamines and analgesic may limit discomfort, pruritis, and decrease local reaction.

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If pts develop symptoms of anaphylaxis then most important agent to give is Epinepherine. 

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Intermittently apply ice to the site to limit local reaction and delay absorption of venom.

Epinepherine 0.3 to 0.5mg (0.3 to 0.5 mL of 1:1000 conc.) in adults and 0.01 mg/kg in children (never more than 0.3 mg) given IM

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Hymenoptera Venom: Treatment

Other treatment should include: 

Diphenhydramine 25 to 50 mg IV, IM or PO

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H2-receptor antagonists (ranitidine 50 mg IV)

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Methylprednisolone 125 mg

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Use Beta agonist nebulization if pt has evidence of bronchospasm

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IVF, oxygen, cardiac monitor, pulse ox.

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Persistent hypotension after multiple IVF bolus may require Dopamine or Epinepherine drip

Killer Bees and Fire Ants

Other Bites and Stings

Stings and bites due to 

Stingray.

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Jellyfish

Marine animals

Stingray

Stingray (cont.) 

Stingrays often cause lacerations and puncture wounds when the tail whips up and thrusts its spines into the victim, injecting venom (poison). The pain is severe immediately and worsens over the next hour. The pain may last 48 hours. Although rare, deaths have occurred from stingray injuries.

first aid 

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As soon as possible, the wound should be soaked for 30-90 minutes in very hot water (as hot as can be endured without causing burns). The heat inactivates the poison and dramatically relieves the pain. Apply wound care.

Stingray ( cont.) When to see a doctor?        

Despite the best of care, any wound can develop infection or other complications. Wound drainage increases, shows pus, or develops a foul odor Wound bleeds heavily Wound becomes more sore or swollen Wound develops increasing redness, or red streaks develop A fever develops Wound does not appear to be healing properly Any other new or worsening symptoms that are of concern.

Jelly fish 

Protect rescuers from contact with the jellyfish or jellyfish tentacles. All rescuers should consider protective clothing and gloves in order to protect themselves so they can better rescue and treat the victim.

Jelly fish sting in action

Jelly fish first aid  

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Remove the victim from the water. Rinse the affected area with salt water or don’t rinse it at all. Do not rinse the involved area of skin with fresh water, because it will further activate nematocysts and worsen the reaction. Using protective gloves or forceps, remove any tentacles still in contact with the victim. Apply acetic acid 5% (white vinegar). This will inactivate undischarged nematocysts and the toxin and will help to decrease symptoms. Use over-the-counter pain medications such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) to control pain symptoms. Immobilize the area that was poisoned to prevent further spread. For example, if a foot was stung, encourage the victim to keep the area still with as little movement as possible.

Jelly fish (cont.) when to go to the hospital? 

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Seek professional medical help immediately by calling *** for any victim displaying continued or worsening swelling, difficulty breathing or swallowing, or severe pain. Any exposure to the eyes, face, mouth, or genitals also requires urgent evaluation by a physician

Sharks  

Attacks are within 100 feet of shore Attacks in early morning, late evening (at feeding times)

Types of Poisons 

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Some poisons are man made (for example Chemicals and Drugs), these are founding the home as well as industry. Almost every household contains substances that are potentially poisonous. Such as BLEACH / PAINT STRIPPER

Types of Poisons 

Over the Counter Medicines which are dangerous if taken in excessive amounts

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Other Poisons occur in NATURE Plants produce poisons that irritate the skin and eyes These cause much more serious if Ingested Insects and creatures produce Venom in their bites and stings

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Toxins are poisons produced via some biological function in nature Venoms are usually defined as biologic toxins that are injected by a bite or sting to cause their effect while other poisons are generally defined as substances which are absorbed through epithelial linings such as the skin or gut.

Route of entry to the body

Swallowed (Ingested)

Poison Drugs and Alcohol Cleaning products DIY and Gardening Products Plant Poisons Bacterial (Food Poisons) Viral (food) poisons

Possible Effects

Action

Nausea and Vomiting Abdominal pains Seizures Irregular or fast slow heart beat Impaired consciousness

Monitor casualty Seek medical help Resuscitate if necessary

Route of entry to the body

Absorbed through skin

Poison Cleaning products DIY and Gardening Products Plant Poisons Industrial poisons

Possible Effects Pain Swelling Rash Redness Itching

Action Remove contaminated clothing Wash area for at least 10 mins Seek medical advice Resuscitate if necessary

Route of entry to the body

Splashed in the Eye

Poison Cleaning products DIY and Gardening Products Plant Poisons Industrial poisons

Possible Effects Pain and Watering of the eye Blurred Vision

Action Irrigate the eye Seek medical advice Resuscitate if necessary

Route of entry to the body

Injected through the skin

Poison Venom from stings and bites Drugs

Possible Effects Pain Redness and swelling at injection site Blurred Vision Nausea and Vomiting Difficulty breathing Seizures Impaired Consciousness Anaphylactic Shock

Action For Sting & Venom Remove Sting, if possible Seek medical advice Resuscitate if necessary

For injected drugs Seek medical advice Resuscitate if necessary

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Contamination of food: by Bacteria may result in Food Poisoning THE MOST COMMON TYPE OF FOOD POISONING Salmonella

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What is salmonella? Salmonella is a type of bacteria. It is usually found in poultry, eggs, unprocessed milk and in meat and water. It may also be carried by pets like turtles and birds.

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What kind of infection does salmonella cause? The salmonella bacteria attacks the stomach and intestines. In more serious cases, the bacteria may enter the lymph tracts, which carry water and protein to the blood, and the blood itself. The bacteria attack all age groups and both sexes. Children, the elderly and people who are already ill are much more likely to get a serious infection.

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What are the symptoms of salmonella poisoning? Diarrhoea or constipation. Headaches. Stomach cramps. ausea and vomiting. Fever. Possibly, blood in the faeces. In the case of less serious infections there are fewer symptoms - usually only diarrhoea two or three times a day for a couple of days. Most mild types of salmonella infection clear up in four to seven days without requiring any treatment other than rest and plenty of liquid.

How can salmonella infections be prevented? Pay attention to cleanliness. Make sure that all food is thoroughly cooked. 

How should food be cooked to avoid salmonella poisoning? The only effective way to kill salmonella bacteria is with heat. For this reason it is essential to cook food thoroughly. Poultry must always be thoroughly cooked or boiled. Minced meat must always be thoroughly cooked or boiled. Never crack a raw egg on a bowl containing other foods - use a knife to crack the shell. In most eggs, the salmonella bacteria exist only on the shell. Eggs should be scalded in boiling water for five seconds before use. 

Home Remedies Egg white- is protein based and the poison attaches itself to it. Milk-is used where poisons are acid based and milk being an alkaline neutralises the acid Syrup of ipecac -commonly referred to as simply Ipecac is derived from the dried rhizome and roots of the ipecacuanha plant and is a well known emetic (substance used to induce vomiting ).

Activated charcoal is estimated to reduce absorption of poisonous substances up to 60%.  It works by adsorbing chemicals, thus reducing their toxicity (poisonous nature), through the entire length of the stomach and small and large intestines (GI tract).  Activated charcoal itself is a fine, black powder that is odorless, tasteless, and nontoxic.  Activated charcoal is often given after the stomach is pumped (gastric lavage). Gastric lavage is only effective immediately after swallowing a toxic substance (within about one-half hour) and does not have effects that reach beyond the stomach as activated charcoal does.

Remember !

Don’t do more harm

Thank You