Bites/Stings

• Anaphylaxis
• Animal Bites
• Human Bites
• Insect Bites and Stings
• Snakebites
• Spider Bites
• Tick Bites

Anaphylaxis

What is it?

A life-threatening allergic reaction (anaphylaxis) can cause shock, a sudden drop in blood pressure and trouble breathing. In people who have an allergy, anaphylaxis can occur minutes after exposure to a specific allergy-causing substance (allergen). In some cases, there may be a delayed reaction, or anaphylaxis may occur without an obvious trigger.

Symptoms:

• Skin reactions, including hives, itching, and skin that becomes flushed or changes color

• Swelling of the face, eyes, lips or throat

• Narrowing of the airways, leading to wheezing and trouble breathing or swallowing

• A weak and rapid pulse

• Nausea, vomiting or diarrhea

• Dizziness, fainting or unconsciousness

Possible Triggers:

• Medications

• Latex

• Foods such as peanuts, tree nuts, fish and shellfish

• Insect stings from bees, yellow jackets, wasps, hornets and fire ants

Plan of Action:

• Immediately call 911 or your local medical emergency number.

• Ask if the person is carrying an epinephrine autoinjector (EpiPen, Auvi-Q, others) to treat an allergic attack.

• If the person needs to use an autoinjector, ask whether you should help inject the medication. This is usually done by pressing the autoinjector against the person's thigh.

• Have the person lie face up and be still.

• Loosen tight clothing and cover the person with a blanket. Don't give the person anything to drink.

• If there's vomiting or bleeding from the mouth, turn the person to the side to prevent choking.

• If there are no signs of breathing, coughing or movement, begin CPR. Do uninterrupted chest presses — about 100 every minute — until paramedics arrive.

• Get emergency treatment even if symptoms start to improve. After anaphylaxis, it's possible for symptoms to start again (recur). Monitoring in a hospital for several hours is usually necessary.

If you're with someone having symptoms of anaphylaxis, don't wait to see whether symptoms get better. Seek emergency treatment right away. In severe cases, untreated anaphylaxis can lead to death within half an hour.

An antihistamine pill, such as diphenhydramine (Benadryl), isn't enough to treat anaphylaxis. These medications can help relieve allergy symptoms, but they work too slowly in a severe reaction.

Animal Bites

What is it?

A bite or claw wound from an animal.

Plan of Action:

To care for a minor animal bite or claw wound, such as one that only breaks the skin, take these steps:

• Wash the wound thoroughly with soap and water.

• Apply an antibiotic cream or ointment and cover the bite with a clean bandage.

Seek prompt medical care if:

• The wound is a deep puncture or you're not sure how serious it is.

• The skin is badly torn, crushed or bleeding significantly — first apply pressure with a bandage or clean cloth to stop the bleeding.

• You notice increasing swelling, redness, pain or oozing, which are warning signs of infection.

• You have questions about your risk of rabies or about rabies prevention. If the bite was caused by a cat or a dog, try to confirm that the animal's rabies vaccination is up to date. If the bite was caused by a wild animal, seek advice from your doctor about which animals are most likely to carry rabies.

• Bats often carry rabies and can infect humans without leaving obvious signs of a bite. This is why the Centers for Disease Control and Prevention recommends that people in contact with bats — or even those who are sleeping and awaken to find a bat in the bedroom — seek medical advice about rabies shots, even if they don't think they've been bitten.

• You haven't had a tetanus shot in the past 10 years — or five years if the wound is deep or dirty. You may need a booster shot.

Human Bites

What is it?

A bite wound from a human.

Human bites can be as dangerous as or even more dangerous than animal bites because of the types of bacteria and viruses contained in the human mouth. Human bites that break the skin can become infected.

If someone cuts his or her knuckles on another person's teeth, as might happen in a fight, this is also considered a human bite. And a cut on the knuckles from your own teeth, such as from a fall, is considered a human bite.

Plan of Action:

To take care of a human bite that breaks the skin:

• Stop the bleeding by applying pressure with a clean, dry cloth.

• Wash the wound thoroughly with soap and water.

• Apply a clean bandage. Cover the affected area with a nonstick bandage.

• Seek emergency medical care.

If you haven't had a tetanus shot within five years, your doctor may recommend a booster. In this case, get the booster shot within 48 hours of the injury.

Insect Bites and Stings

What is it?

A bite or sting from any insect.

Most insect bites and stings are mild and can be treated at home. They might cause itching, swelling and stinging that go away in a day or two. Some bites or stings can transmit disease-causing bacteria, viruses or parasites. Stings from bees, yellow jackets, wasps, hornets and fire ants might cause a severe allergic reaction (anaphylaxis).

Plan of Action:

Mild reactions:

• Move to a safe area to avoid more bites or stings.

• Remove any stingers.

• Gently wash the area with soap and water.

• Apply a cloth dampened with cold water or filled with ice to the area of the bite or sting for 10 to 20 minutes. This helps reduce pain and swelling.

• If the injury is on an arm or leg, raise it.

• Apply to the affected area calamine lotion, baking soda paste, or 0.5% or 1% hydrocortisone cream. Do this several times a day until your symptoms go away.

• Take an anti-itch medicine (antihistamine) by mouth to reduce itching. Options include nonprescription cetirizine, fexofenadine (Allegra Allergy), loratadine (Claritin).

• Take a nonprescription pain reliever as needed.

Seek medical care if the swelling gets worse, the site shows signs of infection, or you don't feel well.

When to seek emergency care:

Call 911 or your local medical emergency number if anyone is having a serious reaction that suggests anaphylaxis, even if it's just one or two signs or symptoms:

• Trouble breathing

• Swelling of the lips, face, eyelids, or throat

• Dizziness, fainting, or unconsciousness

• A weak and rapid pulse

• Hives

• Nausea, vomiting or diarrhea

Take these actions immediately while waiting for medical help:

• Ask whether the injured person is carrying an epinephrine autoinjector (EpiPen, Auvi-Q, others).

• If yes, ask whether you should help inject the medication. This is usually done by pressing the autoinjector against the thigh and holding it in place for several seconds.

• Loosen tight clothing and cover the person with a blanket.

• Don't offer anything to drink.

• If needed, position the person to prevent choking on vomit.

Snakebites

What is it?

A bite from any snake.

Most venomous snakes in North America have eyes like slits and are known as pit vipers. Their heads are triangular and they have fangs. One exception is the coral snake, which has a rounded head and round pupils. Nonvenomous snakes typically have rounded heads, round pupils and no fangs.

Symptoms:

• Pain

• Scratches

• Severe burning pain within 15-30 minutes

• Swelling

• Bruising

• Nausea

• Labored breathing

• Odd taste in the mouth

• Weakness

• Skin tingling

Sometimes, a venomous snake can bite without injecting venom. The result of these "dry bites" is irritation at the site.

If a venomous snake bites you, call 911 or your local emergency number immediately, especially if the bitten area changes color, begins to swell or is painful. Many emergency rooms stock antivenom drugs, which may help you.

If possible, take these steps while waiting for medical help:

• Move beyond the snake's striking distance.

• Remain still and calm to help slow the spread of venom.

• Remove jewelry and tight clothing before you start to swell.

• Position yourself, if possible, so that the bite is at or below the level of your heart.

• Clean the wound with soap and water. Cover it with a clean, dry dressing.

Caution

• Don't use a tourniquet or apply ice.

• Don't cut the wound or attempt to remove the venom.

• Don't drink caffeine or alcohol, which could speed your body's absorption of venom.

• Don't try to capture the snake. Try to remember its color and shape so that you can describe it, which will help in your treatment. If you have a smartphone with you and it won't delay your getting help, take a picture of the snake from a safe distance to help with identification.

 

Spider Bites

What is it?

A bite from any spider.

Most spider bites cause only minor injury but there are a few spider species that can be dangerous.

Plan of Action:

Seek medical care immediately if:

• You were bitten by a dangerous spider, such as a black widow or a brown recluse

• You're unsure whether the bite was from a dangerous spider

• You have severe pain, abdominal cramping or a growing wound at the bite site

• You're having problems breathing or swallowing

• The area of the sore has spreading redness or red streaks.

To take care of a spider bite:

• Clean the wound with mild soap and water. Then apply an antibiotic ointment three times a day to help prevent infection.

• Apply a cool compress over the bite for 15 minutes each hour. Use a clean cloth dampened with water or filled with ice. This helps reduce pain and swelling.

• If possible, elevate the affected area.

• Take an over-the-counter pain reliever as needed.

• If the wound is itchy, an antihistamine, such as diphenhydramine (Benadryl) or certirizine (Zyrtec) might help.

For pain and muscle spasms, your doctor might prescribe pain medicine, muscle relaxants or both. You might also need a tetanus shot.

Dangerous Spiders:

Black Widow spiders

You can usually identify a black widow spider by the red hourglass marking on its belly. In the United States, this spider is more common in the South. It's also found in Europe.

Signs and symptoms of a black widow spider bite can include:

• Redness, pain and swelling

• Severe abdominal rigidity or cramping

• Nausea, vomiting, tremors or sweating

Brown recluse spider

The brown recluse spider has a violin-shaped marking on its back, but this mark can be hard to see. This spider is commonly found in the southern half of the United States and in South America, where it is known as the brown spider.

Signs and symptoms of a brown recluse spider bite can include:

• At first, a mild pain

• Fever, chills and body aches

• A deep blue or purple area around the bite, which may develop a red ring around it

Tick Bites

What is it?

A bite from a tick.

Most tick bites are painless and cause only minor signs and symptoms, such as a change in skin color, swelling or a sore on the skin.

But some ticks transmit bacteria that cause illnesses, including Lyme disease, and Rocky Mountain spotted fever.

In general, to transmit Lyme disease a tick needs to be attached to a person's skin for at least 36 hours. Other infections can be transferred in a few hours or even a few minutes.

Plan of Action:

• Remove the tick promptly and carefully. Use fine-tipped forceps or tweezers to grasp the tick as close to the skin as possible. Gently pull out the tick using a slow and steady upward motion. Avoid twisting or squeezing the tick. Do not handle the tick with bare hands. Do not use petroleum jelly, fingernail polish or a hot match to remove a tick.

• Secure the tick and take a picture. A picture of the tick can help you and your health care provider identify what type it is and whether you are at risk of a transmitted disease. You can trap the tick in a piece of tape for disposal in the garbage. Your provider may want to see the tick or a photo if you develop new symptoms.

• Wash your hands and the bite site. Use warm water and soap, rubbing alcohol, or an iodine scrub.

When to Seek Emergency Care:

• A severe headache

• Difficulty breathing

• Paralysis

• Heart palpitations

When to Contact Your Doctor:

• You aren't able to completely remove the tick. The longer the tick remains attached to the skin, the greater the risk of getting a disease from it. Your skin may also get irritated.

• The rash gets bigger. A small bump may appear at the site of the tick bite. This is typical. If it develops into a larger rash or you develop a rash anywhere, possibly with a bull's-eye pattern, it may indicate Lyme disease. The rash usually appears within 3 to 14 days.

  Consult your provider even if the rash disappears because you may still be at risk of having the disease. Your risk of contracting a disease from a tick bite depends on where you live or travel to, how much time you spend outside in woody and grassy areas, and how well you protect yourself.

• You develop flu-like signs and symptoms. Fever, chills, fatigue, muscle and joint pain, and a headache may accompany the rash.

• You think the bite site is infected. Signs and symptoms include pain, change in skin color or oozing from the site.

• You think you were bitten by a deer tick. You may need antibiotics.

If possible, bring the tick, or a photo of the tick, with you to your doctor's appointment.