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  » First Aid  »  Bites and Stings
Dog bites are the most common type of animal bites. Dogs attack more than a million Americans annually and about half of these incidents involve children.

All children should be taught to avoid strange dogs, and dog owners should properly restrain their pets at all times, keeping them on leashes when walked and muzzled if they have a propensity to bite. Unleashed dogs should be kept in a secure enclosure at other times. These measures not only protect people from bites but they also benefit pets by preventing them from becoming lost or hit by automobiles-common fates for animals allowed to roam freely.

All animal bites require some level of treatment, depending on the nature and severity of the wound. Animal and human mouths are home to many bacteria that can cause harm when they penetrate the skin.

If the person has not had a tetanus shot in the past 5 years, consult a physician. If the person has circulatory problems or diabetes, a physician should also be consulted, even if the bite appears to be minor.

RABIES
Rabies is on the increase in the United States. The Southeast, Middle Atlantic and Northeast states report it at epidemic levels among raccoons, skunks, and bats. Less commonly, rabies may be carried by coyotes, foxes, and larger rodents such as ground hogs. Therefore, any bite from a wild animal should be examined promptly by a knowledgeable doctor.

Any wild animal or unfamiliar domestic animal that bites humans, especially without provocation, should be examined promptly by a knowledgeable doctor. If the animal cannot be found, immunization of the bite victim against rabies may be indicated. (In some instances, people who have merely come in contact with the infected animal or pets that have been in a fight with a rabid animal may also need to be immunized.)

The decision to treat for rabies will be based on the type of animal, its behavior, the geographic location, and other factors. All bites should be reported to the local board of health.

A new rabies treatment, consisting of a single dose of rabies-immune globulin and five injections of human diploid cell rabies vaccine, has greatly simplified the anitrabies shots.

Prophylactic immunization may be indicated for certain individuals in high-risk jobs or when traveling to or residing in high-risk areas. Check with your local board of health for current guidelines.


ANIMAL BITES

To treat a superficial bite from a familiar household pet that is in good health, wash out the wound carefully with soap and water and apply an antiseptic such as hydrogen peroxide and an antibiotic cream. To treat a deeper bite from a familiar, healthy pet or any bite from a strange animal:
  • See a physician as soon as possible if the bite is a puncture wound or large gash; proper cleansing of such wounds is crucial. Stitching may be necessary, depending on the type, location, and severity of the wound. A tetanus shot and antibiotics may also be necessary.
  • Consult a physician promptly if there is any subsequent swelling, pain, increasing redness, or drainage.
  • Notify the pet owner of the incident and determine the animal's rabies inoculation status. Report vicious animals that are permitted to roam freely to the local animal warden or health department.
  • Any flulike symptoms, fever, swollen glands, or other symptoms following an animal bite or scratch should be investigated promptly by a doctor.
HUMAN BITES

Human bites carry a high risk of infection due to the large number of bacteria residing in the human mouth. All human bites should be checked immediately by a doctor, who may administer antibiotics along with other applicable treatments. Whenever the skin is broken because of contact with human teeth—including injury to the knuckles after hitting someone in the mouth—the injured area should be treated by a doctor.

BEE STINGS

The great majority of insect stings cause only minor discomfort from a local reaction. About 1 million Americans are severely allergic to the venom of bees, hornets, yellow jackets, and fire ants. Those who are hypersensitive to bee venom should exercise extreme caution in the outdoors during months when bees are active. They should protect themselves with long pants, long-sleeved shirts, and clothing of subdued colors and patterns that do not attract insects. They should not apply colognes or perfumes. If approached by a bee, sensitive individuals should not panic, duck, or move suddenly, but should stay calm and slowly walk away from the insect.

Hypersensitive individuals who spend a great deal of their time in areas populated by bees (farms, orchards, rural parts of the country) should receive desensitization shots. (See "Allergic Reactions and Anaphylactic Shock" for symptoms of hypersensitive reaction.)

TREATMENT FOR HYPERSENSITIVE INDIVIDUALS
  • Carry a bee sting (anaphylaxis) treatment kit at all times. (These kits are commercially prepared and available by prescription.) Use a syringe preloaded with adrenaline. After administering adrenaline, call the emergency squad or take the person to the nearest hospital emergency room.
  • If a treatment kit is not available, take the person to the nearest hospital emergency room or doctor immediately.
  • If any signs or symptoms of generalized reaction to the bite occur before reaching the hospital, tie a light tourniquet 2 to 4 inches above the bite (between the bite and the trunk of the body).
  • Remove stinger as instructed below.
TREATMENT FOR THE NONSENSITIVE
  • Check the sting site for the venom sac (bee stings only) and stinger. If these are embedded in the skin, remove by scraping over the area with a knife blade, fingernail, or sharp object. Do not try to grasp and pull the stinger out; this action is likely to release more venom into the skin from the venom sac.
  • Apply an ice pack to the sting site or flush it with cold water to reduce swelling and relieve pain.
  • Dab on calamine lotion or a nonprescription corticosteroid cream to ease itching and swelling. Other remedies include unseasoned meat tenderizer, which contains papain, an enzyme that breaks down toxins in the venom. Aspirin or antihistamines may also be used to alleviate moderate, localized reactions.
JELLYFISH, STINGRAY, AND OTHER MARINE ANIMAL BITES

Stings from marine animals are only rarely life-threatening. However, it is wise to avoid swimming in waters infested with jellyfish or other poisonous sea animals. For symptoms of hypersensitive reaction, see "Allergic Reactions and Anaphylactic Shock." TREATMENT FOR HYPERSENSITIVE INDIVIDUALS
  • Calm and reassure the victim.
  • If a jellyfish or Portuguese man-of-war tentacle adheres to the skin, cover it with sand and carefully pull it off—do not rub it off—using a heavy glove, cloth, or towel. Do not touch it with your bare hand or skin. Even when detached from the main organism, this tentacle can sting you.
  • Seek medical attention immediately. Jellyfish stings are most serious when they are numerous, or involve the very young or very old.
TREATMENT FOR INDIVIDUALS WHO ARE NOT HYPERSENSITIVE
  • Remove tentacle or jellyfish as described above.
  • Thoroughly wash the injury and apply rubbing alcohol or vinegar several times, being careful not to touch the sting area with an unprotected hand.
  • Apply a thick coat of baking soda paste, which may be shaved or scraped off after 30 minutes, at which time vinegar or rubbing alcohol is reapplied.
  • Other remedies that can be applied include diluted household ammonia, lemon juice, and salt water.
TREATMENT FOR STINGRAY BITE
  • Wash wound and flush it thoroughly with regular or salt water.
  • Immerse wound in hot water as you transport victim to the nearest hospital emergency room.
SPIDER BITES

The two most common poisonous spiders in the United States are the female black widow and brown recluse. Besides these two spiders, most other bites of spiders in North America are harmless, causing minor, localized reactions. Black Widow Spider. The black widow spider is a small, black spider with a red, hourglass marking on its abdomen. SYMPTOMS
  • There is only a slight local reaction—with some pain—at the site of the bite.
  • The neurotoxin injected by the spider may cause pain, muscle spasm, and paralysis in distant parts of the body.
  • Vomiting and abdominal cramps.
TREATMENT
  • Apply an ice pack to the area of the bite immediately.
  • If shock occurs, take appropriate measures.
  • Take the victim to the nearest hospital as soon as possible. Treatment usually entails the administration of muscle relaxants and pain medication. Although an antivenin is available, it is not necessary in most cases.
Brown Recluse. The brown recluse is a small spider that has a violin-shaped marking on its upper back. It is usually found in attics and out-of-the-way corners.

SYMPTOMS
  • The bite may not become apparent for several hours or days. But then a red lesion appears that becomes a blister.
  • The appearance of the blister may be followed by fever, nausea, and a body rash.
  • Blister may enlarge into a very painful ulceration.
TREATMENT
  • Apply an ice pack to the area of the bite immediately.
  • If shock occurs, take appropriate measures.
  • Take the victim to the nearest hospital as soon as possible. Medical evaluation is extremely important. Surgery may be necessary to repair the ulcerated area.

SNAKE BITES

While there are about 45,000 snakebites a year in the United States, only about 7,000 of these injuries involve poisonous snakes, resulting in about 10 deaths annually, only one-fourth the number that die from bee stings. Poisonous snakes are found in every state except Maine and Alaska. Sixty percent of the venomous snakebites are caused by rattlesnakes; the other 40 percent result from bites from copperheads, cottonmouths (water moccasins), and coral snakes. Although not all bites from poisonous snakes result in the release of poison, once the skin is punctured by snake fangs you should assume that poison is present and act accordingly. It is urgent that a snakebite victim be taken to a hospital for antivenin serum as quickly as possible, certainly within 4 hours. (The serum is not effective if administered more than 12 hours after the bite.) Hikers or campers who plan trips to remote areas without easy access to transportation or medical assistance should carry a snakebite kit and be trained in its proper use. Hikers should also know how to distinguish between two major types of venomous snakes.
  • Pit Vipers. This family of snakes includes rattlesnakes, copperheads, and cottonmouths. They have triangular heads with a pit between the nostril and eye on both sides of the head, elliptical pupils, and two fangs. All pit viper bites are treated with the same antivenin.
  • Coral Snakes. Also called the harlequin or bead snake. Coral snakes are banded in red and black interspersed with white or yellow rings. They have teeth, fangs, a black snout, and lack facial pits. An easy way to distinguish this type from nonpoisonous banded snakes: "Red on yellow/kill a fellow;/red on black/good for Jack."
TREATMENT OF SNAKE BITES
  • Reassure the person and keep him supine and as quiet as possible.
  • Try to identify the snake but do not waste time looking for it if it has disappeared. If you are not sure of the snake's type, but it is easy to kill without danger to yourself, do so with extreme caution. Remember that a snake's biting reflex allows it to still bite up to 60 minutes after it has died. For proper treatment with the correct antivenin, it is especially important to identify an exotic snake from a zoo or one kept as a pet.
  • Apply a light constricting band 2 to 4 inches above the bite if it is on an extremity. Do not totally restrict blood flow; check to make sure that a pulse is present below this light tourniquet. If swelling takes place at the level of the band, remove and replace it a few inches above the swelling.
  • Do not allow the victim anything to eat or drink. Especially do not allow the ingestion of alcoholic beverages (this includes beer, wine, and wine coolers).
  • Bring the victim to the nearest hospital or emergency service.
  • If you are far from a hospital, you should suck the venom out of a poisonous snake bite within ten to fifteen minutes after being bitten: Use a sterilized razor to make quarter-inch deep incisions along the fang marks. (But cut lengthwise on arms and legs, not across. And do not make incisions over a coral snake bite.) If available, use the suction cup supplied with snake bite kits to withdraw the venom. Otherwise suck it out by mouth, but do not swallow—spit the venom out. Rinse your mouth afterward, if possible. Do not suck the venom out if you have a cut or sore in your mouth. After withdrawing the venom, take the victim to an emergency room as soon as possible.
TICKS

Ticks are parasites that feed on warm-blooded vertebrates. Some ticks are harmless; others carry a variety of diseases, including Rocky Mountain spotted fever and Lyme disease. Although the names imply that these diseases are confined to particular geographical areas, in fact, Rocky Mountain spotted fever occurs in all states except Maine, Alaska, and Hawaii, and Lyme disease has been reported in most states.

PREVENTING TICK BITES
  • In areas with heavy tick populations such as woods, dense brush, or high grass, stay on well-worn trails.
  • Wear proper protective clothing such as long pants, boots, and a long-sleeved shirt. Apply an insect repellant that protects against ticks.
  • Keep shirt tucked in to keep insects out of your clothing. Inspect your clothing and skin regularly for the presence of ticks.
  • Shower and wash your hair. It takes 4 to 6 hours for most ticks to become firmly attached, and showering is a quick way to rid yourself of loose ticks.
  • Inspect pets that venture into tick-infested areas at least daily and remove any ticks.
TREATMENT
  • Do not try to remove the tick by rubbing or pulling it out. This may leave the head imbedded in the skin.
  • Although experts disagree on this point, we recommend covering the tick with a few drops of thick oil such as olive or mineral oil, or kerosene or gasoline. This will suffocate and immobilize the tick.
  • Gently remove the tick with a pair of tweezers, taking care to remove the head. Do not handle or crush the tick between your fingers. (Use the same caution in removing ticks from dogs and other pets.)
  • Carefully wash the bite area as well as your hands and the tweezers with soap and water. Apply alcohol or hydrogen peroxide to the area and cover with a sterile bandage.
  • Consult a doctor to see if further treatment is needed. Take particular note of symptoms such as fever, rash, generalized aches and pains, headaches, or other signs of illness following a tick bite. If symptoms occur, see a doctor at once.