Bites, Stings and Poisons

Don’t do more
harm
Bites And Stings
 Rinse all bites 5 minutes with water
 (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 ?
* 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
 Bats
 Foxes
 Skunks
Bites and Rabies
 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
 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
 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
 Mark extent of swelling on body
 6-10 hours later: potential discoloration
and blood filled blisters
Coral Snake Bites
 Most venomous, but rarely bites
 Red, yellow and black bands
 Every other band is yellow
 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
 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 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
 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
 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
 Not life
threatening
 Treatment
 Cortisone cream
 Antihistamines
(benadryl)
 Black Widow Bites

 Bite:
 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:
 Skingrafting
 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
 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)
 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
 Why ? Dangerous.
 How?
 What first aid?
If you sustain a human bite that breaks the skin:
1. 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.

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

 Now found in Texas, Arizona, California, and

most of the temperate southeastern and
southwestern states.

 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
 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
 Keep anaphylaxis in mind
 Epinephrine
 Re-inject after 15 minutes if
necessary
 Watch for delayed allergic reaction
(possibly the next day)
 Hymenoptera Venom: Treatment
 Immediate removal of the bee
stinger from the wound, is the
important principle rather than
the method of removal.
 Wash the sting site with soap
and water to decrease risk of
infection.
 Intermittently apply ice to the
site to limit local reaction and
delay absorption of venom.
 Oral antihistamines and
analgesic may limit discomfort,
pruritis, and decrease local
reaction.
 If pts develop symptoms of
anaphylaxis then most important
agent to give is Epinepherine.
 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
 Hymenoptera Venom: Treatment
 Other treatment should include:
 Diphenhydramine 25 to 50 mg IV, IM or PO

 H2-receptor antagonists (ranitidine 50 mg IV)

 Methylprednisolone 125 mg

 Use Beta agonist nebulization if pt has evidence of bronchospasm

 IVF, oxygen, cardiac monitor, pulse ox.

 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 Marine animals
 Stingray.

 Jellyfish
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
 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
 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?
 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
 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
 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
 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 Poison Possible Action
to the body Effects
Swallowed Drugs and Nausea and Monitor
(Ingested) Alcohol Vomiting casualty
Cleaning Abdominal Seek
products pains
DIY and medical help
Seizures Resuscitate
Gardening Irregular or fast
Products if necessary
slow heart beat
Plant Impaired
Poisons consciousness
Bacterial
(Food
Poisons)
Viral (food)
poisons
Route of entry Poison Possible Action
to the body Effects
Absorbed Cleaning Pain Remove
through skin products Swelling contaminated
DIY and clothing
Rash Wash area for
Gardening Redness at least 10
Products Itching mins
Plant Seek medical
Poisons advice
Industrial Resuscitate if
necessary
poisons
 Route of entry Poison Possible Action
to the body Effects
Splashed in Cleaning Pain and Irrigate the
the Eye products eye
Watering of Seek medical
DIY and the eye advice
Gardening Blurred Resuscitate
Products Vision if necessary
Plant
Poisons
Industrial
poisons
Route of entry Poison Possible Action
to the body Effects
Injected Venom Pain For Sting &
through the from Redness and Venom
skin stings and swelling at Remove Sting,
injection site if possible
bites Blurred Vision Seek medical
Drugs Nausea and advice
Vomiting Resuscitate if
Difficulty necessary
breathing
Seizures For injected
Impaired drugs
Consciousness Seek medical
Anaphylactic advice
Shock Resuscitate if
necessary
 Contamination of food: by Bacteria may
result in Food Poisoning
 THE MOST COMMON TYPE OF FOOD
POISONING
 Salmonella
 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.
 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.
 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