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Chapter 19 Bites and Stings
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Animal Bites (1 of 2) It is estimated that one of every two Americans will be bitten at some time by an animal or person. Dog bites equal about 80% of these injuries. Immediate tissue damage and later infection are two concerns of animal bites. © Chuck Stewart, MD
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Animal Bites (2 of 2) Children and elderly people are especially prone to animal bites. Damage mostly occurs on the hands, arms, legs, and face. Wild animal attacks occur most often in rural or wilderness locations.
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Rabies (1 of 3) One of the most ancient and feared of diseases
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Rabies (2 of 3) Caused by a virus found in warm-blooded animals
Spreads from one animal to another in the saliva A bite or scratch is considered exposure if it penetrates the skin. Nonbite exposure consists of contamination of wounds.
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Rabies (3 of 3) Consider an animal rabid if the animal:
Made an unprovoked attack Acted strangely Was a high-risk species Report animal bites to police or animal control.
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Recognizing an Animal Bite
Puncture wound Tissue and skin crushed Open wound on fingers, knuckles, and/or hand
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Care for Animal Bites If the wound is not bleeding heavily, wash it with soap and water. Control the bleeding with direct pressure. Cover the wound with sterile or clean dressing. Seek medical care.
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Human Bites Human bites can cause severe injury.
Most are acts of violence. Most common injury location is the hand.
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Recognizing Human Bites
True bites: Part of the body’s flesh is caught between teeth. Clenched-fist injury: Results from cutting a fist on teeth High likelihood of infection
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Care for Human Bites If the wound is not bleeding heavily, wash it with soap and water for 5 to 10 minutes. Flush with running water under pressure. Control bleeding with direct pressure. Cover with sterile dressing. Do not close the wound. Seek medical care.
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Snake Bites (1 of 7) About 50,000 people throughout the world die of snake bites each year. In the United States 40,000 to 50,000 people are bitten by snakes, 7000 to 8000 of them by venomous snakes.
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Snake Bites (2 of 7) Four species of venomous snakes in the United States: Rattlesnakes Copperheads Water moccasins Coral snakes
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Snake Bites (3 of 7) Snake bites can be painful, costly, and potentially deadly. Partial or complete loss of an extremity or finger or loss of movement in a joint can occur. Most victims recover.
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Snake Bites (4 of 7) Rattlesnakes, copperheads, and water moccasins are pit vipers. Triangular, flat heads Elliptical pupils A heat-sensitive pit © AbleStock Courtesy of Ray Rauch/U.S. Fish and Wildlife Service Courtesy of South Florida Water Management District
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Snake Bites (5 of 7) Coral snakes Small and colorful
Series of bright red, yellow, and black bands around its body © Rolf Nussbaumer/age fotostock
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Snake Bites (6 of 7) At least one species of venomous snake is found in every state except Alaska, Hawaii, and Maine.
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Snake Bites (7 of 7) Legitimate snake bite: Illegitimate snake bite:
Bitten before the encounter with a snake was recognized Bitten while trying to move away Most often involve the lower extremities Are accidental Victim recognized the encounter with a snake. Did not attempt to move away Most often occur on the upper extremities Most often occur when the victim tries to kill, capture, play with, or move a snake
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Pit Vipers Pit vipers are found in every state but Alaska, Maine, and Hawaii. Rattlesnakes are the most widespread. Keep the rodent population under control.
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Recognizing Pit Viper Bites
Severe burning pain Two small puncture wounds Swelling Discoloration Blood-filled blisters Nausea, vomiting, sweating, weakness
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Care for Pit Viper Bites
Get victim away from snake. Do not attempt to capture or kill the snake. Keep victim quiet. Gently wash area with soap and water. Remove rings or other jewelry. Stabilize the extremity. Keep the extremity below heart level. Seek medical care.
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Coral Snake Bites America’s most venomous snake Rarely bite people
Venom is a neurotoxin. Symptoms begin 1 to 5 hours after the bite.
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Recognizing Coral Snake Bites
Minimal pain Sagging or drooping upper eyelids Weakness Pricking, tingling of skin Double vision Difficulty swallowing Sweating Abnormal flow of saliva
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Care for Coral Snake Bites
Keep victim calm. Gently clean with soap and water. Apply mild pressure. Seek medical care.
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Nonpoisonous Snake Bites
Nonvenomous snakes inflict the most bites. Assume a snake is venomous if you don’t know what type it is.
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Recognizing Nonpoisonous Snake Bites
Mild to moderate pinch Curved lines of tiny pinpricks on the skin that correspond with the rows of sharp, pointy teeth Bleeding Mild itching
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Care for Nonpoisonous Snake Bites
Gently clean with soap and water. Care for the bite as you would a minor wound. Seek medical care.
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Insect Stings (1 of 2) Honeybees Bumblebees Yellow jackets Hornets
Wasps Fire ants © Dwight Lyman/ShutterStock, Inc. © Borut Gorenjak/ShutterStock, Inc. © pixelman/ShutterStock, Inc. © Heintje Joseph T. Lee/ShutterStock, Inc.
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Insect Stings (2 of 2) These insects account for more deaths and illnesses each year than all other venomous animals combined. About 1 in every 200 people is dangerously allergic to stinging insect venom.
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Insect Stings Honeybees and Some Yellow Jackets
Have barbed stingers Barbed stingers become embedded in the victim’s skin during the sting. Die after the sting
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Insect Stings Honeybees and Bumblebees
Do not release all their venom during initial injection Some venom remains in the stinger embedded in the victim’s skin. This venom worsens the victim’s reaction.
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Insect Stings Wasps, Yellow Jackets, Hornets, and Fire Ants
Stingers are not barbed. Stingers do not embed in victim. Can sting multiple times Most do not die after stinging. Courtesy of Scott Bauer/USDA
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Insect Stings Yellow Jackets
Wasp Can sting multiple times Ground-nesting bee Stings once, then dies Smaller than yellow jacket wasps
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Reactions to Insect Stings (1 of 2)
Most stings cause only self-limited, local inflammatory reactions. Pain Itching Redness Swelling Courtesy of Daniel Wojcik/USDA
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Reactions to Insect Stings (2 of 2)
Swelling and redness Nausea Vomiting Wheezing Fever Drippy nose Anaphylaxis Generally occurs within few minutes to 1 hour Throat swelling Bronchospasm
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Multiple Insect Stings
Five hundred stings will usually kill even people who are not allergic to stinging insects. Massive numbers of stings are rare. Africanized bees are also known as killer bees.
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Recognizing Insect Stings (1 of 2)
Life-threatening reactions: Bluish or grayish skin color Seizures Unresponsiveness Inability to breathe Usual reactions: Instant pain Redness at site Itching Worrisome reactions: Hives Swelling of lips or tongue Tickle in throat Wheezing
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Recognizing Insect Stings (2 of 2)
Lack of uniformity in victims’ responses Stings to the mouth or eye tend to be more dangerous. Victims tend to react more severely to multiple stings, especially 10 or more. The most dangerous single stings in nonallergic individuals are those inside the throat.
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Care for Insect Stings Remove stinger and venom sac.
Wash with soap and water. Apply an ice pack. Give pain medication, topical steroid cream, or antihistamine. Observe the victim for 30 minutes. Use epinephrine only for severe allergic reaction. Watch for delayed allergic reaction.
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Spider and Insect Bites
Most spiders are venomous, but most lack long fangs and strong jaws to bite a human. About 60 species of spiders in North America are capable of biting humans.
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Black Widow Spiders (1 of 2)
Also known as brown widow spiders and red-legged spiders Only three of the five species are actually black. © photobar/ShutterStock, Inc.
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Black Widow Spiders (2 of 2)
Females are one of the largest spiders. Fangs can penetrate human skin. Shiny black abdomens with red or yellow spot or white spots or bands Produce one of the most potent venoms Found throughout world Extensive, irregular, shaggy web
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Recognizing Black Widow Spider Bites
Victim might feel a sharp pinprick. Two tiny red spots might be seen. Within 15 minutes to 4 hours, muscle stiffness and cramps occur. Headache, chills, fever, sweating, dizziness, nausea, and vomiting Severe pain around bite peaks in 2 to 3 hours.
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Care for Black Widow Spider Bites
Catch spider if possible. Clean bite area with soap and water or rubbing alcohol. Place an ice pack over the bite. Give pain medication. Monitor breathing. Seek medical care immediately.
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Brown Recluse Spiders Also known as fiddle-back and violin spiders in North America Violin shape on back Fawn to dark brown Male and female are venomous. Primarily in the southern and midwestern states Courtesy of Kenneth Cramer, Monmouth College
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Recognizing Brown Recluse Spider Bites
Local reaction usually within 2 to 8 hours Mild to severe pain at the bite site Redness, swelling, and local itching Blister forms at site in 48 to 72 hours Bull’s-eye pattern Volcano lesions Fever, weakness, vomiting, joint pain, rash Stomach cramps, nausea, vomiting
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Care for Brown Recluse Spider Bites
Catch spider if possible. Clean bite area with soap and water or rubbing alcohol. Apply an ice pack. Give pain medication. Seek medical care immediately.
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Tarantulas Bite only when provoked or roughly handled
When upset, scratches abdomen and flicks hairs onto a person © Nick Simon/ShutterStock, Inc.
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Recognizing Tarantula Bites and Embedded Hairs
The bite causes pain, aching, or stinging. The hairs cause itching and inflammation that can last several weeks.
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Care for Tarantula Bites
Catch spider if possible. Clean bite area with soap and water or rubbing alcohol. Apply an ice pack. Give pain medication. Seek medical care immediately.
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Care for Embedded Tarantula Hairs
Remove hairs with sticky tape. Wash with soap and water. Apply hydrocortisone cream. Give the victim pain medication. Give the victim an antihistamine.
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Recognizing Common Aggressive House Spider Bites
Similar to those of the brown recluse spider Redness, blisters, and later, dead tissue Headache, visual problems, weakness
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Care for Common Aggressive House Spider Bites
Catch spider if possible. Clean bite area with soap and water or rubbing alcohol. Apply an ice pack. Give pain medication. Seek medical care immediately.
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Scorpion Stings (1 of 2) Look like miniature lobsters
Pincers and long, up-curved taillike appendage with poisonous stinger © David Desoer/ShutterStock, Inc.
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Scorpion Stings (2 of 2) Bark scorpion is the only threat to humans.
Found primarily in Arizona Pale tan color Three fourths of an inch to 1.25 inches long Stings to adults are usually not life threatening. Stings to small children may be dangerous.
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Recognizing Scorpion Stings
Local immediate pain and burning Later, numbness or tingling No swelling or blanching Tapping finger over site causes pain. Pain or even paralysis in severe cases Uncontrolled jerking movements and facial twitching
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Care for Scorpion Stings
Monitor breathing. Gently clean with soap and water or rubbing alcohol. Apply an ice pack. Give pain medication. Seek medical care.
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Centipede Bites Giant desert centipede is only US centipede dangerous to humans. Up to 8 inches long Can inject toxic substances Venom is relatively weak
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Recognizing Centipede Bites
Burning pain Local inflammation Mild swelling of lymph nodes Inflammation, swelling, redness lasting 4-12 hours Swelling and tenderness can last 3 weeks, or disappear and recur.
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Care for Centipede Bites
Clean the wound with soap and water. Apply an ice pack. Give pain medication. Seek medical care for severe reactions.
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Mosquito Bites In developing countries, mosquitoes transmit malaria, yellow fever, dengue fever. In the United States, they carry encephalitis. Need blood to lay eggs Breed in water Most bite at twilight.
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Care for Mosquito Bites
Wash with soap and water. Apply an ice pack. Apply calamine lotion or hydrocortisone ointment. Antihistamine every 6 hours or cortisone might be useful.
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Embedded Ticks (1 of 2) Close relatives of mites and spiders
Classified as hard ticks or soft ticks Carry diseases, are nuisance, cause paralysis Need blood meal to grow Limited in ability to find meals Bites are nearly painless.
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Embedded Ticks (2 of 2) Front part consists of the head area and the mouthparts. Hypostome Barbs Most tick bites are harmless.
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Care for Embedded Ticks
Use tweezers or specialized tick removal tool. Grasp tick as close to skin as possible. Lift with enough force to tent the skin. Hold until tick lets go. Do not pull hard enough to break the tick apart.
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Care for Embedded Ticks After Removal (1 of 2)
Wash with soap and water. Apply rubbing alcohol. Apply an ice pack. Apply calamine lotion. Keep the area clean. Watch bite site for rash for 1 month.
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Care for Embedded Ticks After Removal (2 of 2)
Seek medical care if: Rash Fever Muscle aches Sensitivity to light Paralysis begins with leg weakness Courtesy of James Gathany/CDC
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Marine Animal Injuries
Most marine animals bite or sting in defense rather than attack.
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Sharks The chance of being attacked by a shark along the North American coastline is less than 1 in 5 million. Most attacks occur within 100 feet of shore. Most victims are attacked without warning. The leg is the most frequently bitten part. Sharks are attracted to chemicals found in fish blood.
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Recognizing a Shark Bite
Severe bleeding Large, open wounds, most often on legs Abrasions from contact with sharkskin © AbleStock
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Care for a Shark Bite or Puncture
Control bleeding. Treat for shock. Seek medical care.
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Barracudas and Moray Eels
Barracuda bites are rare. Moray eels are frequent biters of divers who handle or tease them.
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Recognizing Barracuda and Moray Eel Bites
Barracuda lacerations are similar to those of a shark. Eel bites involve severe puncture wounds with narrow jaws.
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Care for Barracuda and Moray Eel Bites
Care for a barracuda bite as you would a shark bite. Care for an eel bite: Flush the wound with water under pressure. Control the bleeding.
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Marine Animals That Sting
Each year, jellyfish, Portuguese man-of-wars, corals, and anemones that lie along the shallow ocean waters of the United States sting more than 1 million people. Jellyfish and Portuguese man-of-wars have long tentacles equipped with stinging devices called nematocysts.
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Portuguese Man-of-War Sting
Well-defined linear welts or scattered patches of welts with redness Usually disappear within 24 hours Courtesy of NOAA
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Jellyfish Sting Produces severe muscle cramping
Multiple, thin lines of welts in a zigzag pattern Burning type pain Welts disappear within an hour. © Nir Levy/ShutterStock, Inc.
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Anemone Sting Potentially dangerous Result from improper handling
© Roger Dale Calger/ShutterStock, Inc.
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Recognizing Marine Animal Stings
Stinging Severe itching and burning Prickling, tingling Blisters Severe allergic reaction Difficulty breathing Muscle cramping Nausea, vomiting
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Care for Marine Animal Stings
Apply vinegar for at least 30 seconds. Baking soda paste will work too. Use hot water immersion for at least 20 minutes. Hot dry pack will work too. Apply a coating of hydrocortisone several times a day.
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Stingrays Most wounds inflicted by stingrays are produced on the ankle or foot when the victim steps on the ray. At least 1500 stingray injuries occur each year in coastal US waters. The tail barb of a stingray easily penetrates human skin.
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Recognizing a Stingray Puncture
Sudden, intense pain Open wound Swelling © AbleStock
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Care for a Stingray Puncture
Immerse the injured part in hot water for 30 to 90 minutes. Wash the wound with soap and water. Irrigate with water under pressure. Treat like any puncture wound.
