Chapter 23

First Aid for Colleges

and Universities
10th Edition

Bites and Stings

Slide Presentation prepared by

Randall Benner, M.Ed., NREMT-P

© 2012 Pearson Education, Inc.

Learning Objectives

• Distinguish between poisonous and

nonpoisonous snakes.
• List the factors that determine the severity of a pit
viper bite.
• List the signs and symptoms of a pit viper bite.
• List the signs and symptoms of a coral snake bite.
• Determine when medical help is needed for an
insect bite.

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Learning Objectives

• List the signs and symptoms of a black widow

spider bite.
• Explain why the bite of the brown recluse spider
is so serious.
• List the signs and symptoms of a scorpion sting.
• List the signs and symptoms of anaphylactic
shock.

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Learning Objectives

• Identify the two important differences between

the bites and stings of marine animals and those
of land animals.
• Describe and demonstrate first aid care for bites
and stings.
• Describe and demonstrate first aid care for
marine life poisoning.
• Describe and demonstrate how to remove a tick.

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Introduction

• Although common, insect bites and stings are

mostly minor.
• Although rare, some victims may develop
anaphylactic shock.
• Proper first aid care for insect bites/stings and
snake bites can save lives and prevent tissue
damage.

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Snakebite

• 45,000 snakebites a year; 8,000 venomous

• Only four kinds of poisonous snakes native to
United States
– Rattlesnakes
– Coral snakes
– Water moccasins (cottonmouth)
– Copperheads
• Nonpoisonous snakebites not considered
serious

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Snakebite

• Characteristics of a poisonous snake

– Large fangs
– Vertical slits for pupils
– Heat sensitive pit between the eye (pit viper)
– Triangular head is larger than neck
– Certain color blotches on scales

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Snakebite

• Severity of a snakebite is determined by:

– Location of the bite
– Presence of disease-causing organisms in venom
– Size and weight of victim
– Health condition of victim
– Physical exertion of victim following bite

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Snakebite

• Signs and symptoms of a snakebite

– Two distinct fang marks
– Immediate severe burning pain with swelling
– Purplish discoloration and blood-blisters around the
bite
– Numbness around the site

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Snakebite Signs and Symptoms

Poisonous snakebite to the hand. Rattlesnake bite to the leg.

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Snakebite Overview

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Snakebite

• Severe reaction symptoms

– Nausea and vomiting
– Tachycardia and hypotension
– Muscle twitching, possible seizures
– Weakness and/or fainting
– Sweating, fever, chills
– Dimmed vision, peculiar taste in mouth
– Headache
– Coral snakebites may display tiny semicircular
scratches.

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Insect Bites and Stings

• Generally not life-threatening

• General signs and symptoms
– Mark on skin
– Pain or tenderness local to bite or sting
– Redness and swelling at site
– Possible remnant of insect at site (venom sac, stinger,
tentacle, etc.)
• Severity also based on general health of the
victim, and certain findings from assessment

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Insect Bites and Stings

• Black widow spider

– Most painful spider bite and causes most deaths
– Particularly dangerous to the young and elderly,
or people with chronic conditions
– General symptoms
• Sharp pain with bite that turns dull
• Muscle spasms to shoulders, back, abdomen, chest
• Fever, chills, sweating
• Headache, dizziness, restlessness
• Anxiety, weakness
• Drooping eyelids

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Insect Bites and Stings

• Brown recluse spider

• General symptoms
– Painless bite
– Eventual redness with itching and swelling
– Formation of blood-filled blisters
– Possible “halo” pattern around bite
– Eventual ulceration appears that can only be treated
by surgery and skin grafting

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Insect Bites and Stings

• Brown recluse spider bite

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Insect Bites and Stings

• Scorpion
– Common to southwest U.S., and dry areas of Utah
and Nevada
– Severity of sting depends on amount of venom
injected
– Symptoms
• Heavy salivation
• Dyspnea and difficulty swallowing
• Poor coordination
• Incontinence
• Seizures

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Insect Bites and Stings

• Fire ants
– Most common in southeastern U.S.
– Ants bite into skin, then pivot around while stinging
– Symptoms
• Painful blisters
• Large local reaction of swelling, pain, and redness
• Possible anaphylactic shock (rare)

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Insect Bites and Stings

• Fire ant bites

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Insect Bites and Stings

• Ticks
– Can transmit certain diseases to humans
• Rocky Mountain spotted fever
• Lyme disease
– Usually visible after they’ve attached themselves to
the skin and have become engorged with blood

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Insect Bites and Stings

• Centipedes
– Giant centipede is the only dangerous type
– Bite results in injection of venom
– Causes swollen lymph glands
• Insect stings
– Honeybee, bumblebee, wasp, hornet, yellow jacket,
Africanized bees
– Most serious stings occur when stung in mouth or
throat
– Allergic reactions can be dangerous.

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Types of Wasps, Bees and Ants

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Insect Bites and Stings

• Anaphylactic shock
– Results in airway closure, bronchoconstriction,
hypotension, and possible death
– Victim may benefit from, or already have, epinephrine
auto-injector pen (epi pen)
– Severest attacks come on rapidly
• Initiate EMS
• Loosen tight clothing
• Place in shock position
• Use epi pen as directed and prescribed
– Refer to Chapter 6 for details on anaphylactic shock

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Marine Life Bites and Stings

• 2,000 poisonous marine animals

• Most are nonaggressive
• May cause allergic reaction
• Mechanism of injury may be tearing of tissue
(shark), puncture injuries (stingray), or stings
(coral, anemone, jellyfish, etc.)
• Two important differences from land animals
– Venom is more severe in marine life
– Venom is destroyed by heat, not cold

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Marine Life Bites and Stings

Jellyfish sting. Stingray sting.

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First Aid for Bites and Stings

• General first aid

– Activate EMS, take precautions.
– Remove stinger as needed, wash wound
with soap.
– Remove jewelry and other constricting objects.
– Apply cold compress to site (except for marine).
– Apply paste of baking soda and water for bee sting;
use vinegar or lemon juice for wasps.
– Observe for signs of anaphylactic reaction,
use epi pen if needed and prescribed.
– Keep patient calm, reassess often.

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Allergic Reaction to Insect Bite

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First Aid for Snakebite

• Activate EMS, take standard precautions.

• Do not cut skin, suction wound, or apply ice.
• Treat nonpoisonous bite as soft tissue injury.
• For poisonous bites, splint extremity and apply a
pressure immobilization bandage.
• Monitor victim until medical help arrives or the
victim is delivered to medical care.

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First Aid for Marine Life Poisoning

• Remove victim from water if needed.

• Activate EMS, take standard precautions.
• Wash the affected site.
• Immerse area in hot (not scalding) water.
• Use tweezers to remove any bite/sting
remnants.
• Do not remove deeply embedded spines.
• Monitor regularly until medical help assumes
care.

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Removing a Tick

• Never attempt removal of tick that is embedded

in the skin.
• If head is attached, grasp close to attachment
point at skin with tweezers.
• Pull slowly and firmly until dislodged.
• Wash bite area thoroughly with soap and water.
• Apply cold pack or Calamine lotion to relieve
pain and swelling.
• Advise victim to report bite to physician and seek
follow-up medical attention.

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Summary

• Most bites and stings are nonlethal.

• Some marine life, reptiles, and insects can inject
venom or barbs that can seriously damage body
tissues and organs.
• Attempt to determine source of bite/sting if it can
be done safely.
• Basic management includes soft tissue trauma
care with specific interventions based on
offending source.

© 2012 Pearson Education, Inc.