Chapter 19Bites and Stings

Animal Bites

• Two concerns result from an animal bite:− Immediate tissue damage− Later infection from microorganisms

• Dogs are responsible for the majority of all animal bite injuries.

© E.M. Singletary, M.D. Used with permission.

Animal Bites

• Children and older 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.

Rabies

• One of the most ancient and feared of diseases

Data from Centers for Disease Control and Prevention.

Human Bites

• Human bites can cause severe injury.− Most are acts of violence.− Most common injury location is the hand.

© American Academy of Orthopaedic Surgeons.

Snake Bites

• About 100,000 people die of snake bites each year.

• In the United States, 7,000 to 8,000 are bitten by venomous snakes annually.

Snake Bites

• Four species of venomous snakes in the United States− Rattlesnakes− Copperheads− Water moccasins− Coral snakes

© Jones & Bartlett Learning.

© Jones & Bartlett Learning.

Snake Bites

• At least one species of venomous snake is found in every state except Alaska, Hawaii, and Maine.

© Jones & Bartlett Learning.

Legitimate Snake Bites

• Bitten before the encounter with a snake was recognized

• Bitten while trying to move away• Most often involve the lower extremities• Are accidental

Illegitimate Snake Bites

• Person recognized the encounter with a snake

• Did not attempt to move away• Most often occur on the upper extremities• Most often occur when the person tries to

kill, capture, play with, or move a snake

Pit Viper Bites: What to Look For

• Severe burning pain• Two small puncture

wounds• Swelling• Discoloration• Blood-filled blisters• Nausea, vomiting,

sweating, weakness© American Academy of Orthopaedic Surgeons.

© American Academy of Orthopaedic Surgeons.

Pit Viper Bites: What to Do

• Call 9-1-1.• When possible, carry the person.• Do not apply a pressure bandage.

Coral Snake Bites

• America’s most venomous snake• Rarely bite people• Venom is a neurotoxin.• Symptoms begin 1 to 5 hours after the bite

Coral Snake Bites: What to Look For

• Several hours may pass before the onset of:− Minimal pain− Sagging or drooping upper eyelids− Weakness− Pricking, tingling of skin− Double vision− Difficulty swallowing− Sweating− Abnormal flow of saliva

Coral Snake Bites: What to Do

• Call 9-1-1.• Apply a wide elastic bandage.• Stabilize the bitten arm or leg and keep it

below heart level.• Do not cut skin or use suction.

Other Reptile Bites

• Venomous lizards include:− Gila monster− Mexican bearded lizard

• Venomous lizards may hang on chew venom into person’s skin.

Other Reptile Bites: What to Look For

• Puncture wounds• Swelling and pain• Sweating• Vomiting• Increased heart rate• Shortness of breath

Other Reptile Bites: What to Do

• Give pain medication.• Call 9-1-1.• Treat the bite the same as you would for a

pit viper bite.

Insect Stings

• Honeybees• Bumblebees• Yellow jackets• Hornets• Wasps• Fire ants

© Borut Gorenjak/Shutterstock. © Dwight Lyman/Shutterstock.

© pixelman/Shutterstock.

© Heintje Joseph T. Lee/Shutterstock.

Insect Stings: Wasps, Hornets, and Fire Ants

• Stingers do not embed in person.

• Can sting multiple times

• Most do not die after stinging.

Courtesy of Scott Bauer/USDA

Reactions to Insect Stings

• Most stings cause only self-limited, local inflammatory reactions.− Pain− Itching− Redness− Swelling

Courtesy of Daniel Wojcik/USDA.

Spider and Insect Bites

• Most spiders are venomous.• About 60 species in North America

are capable of biting humans.

© Jones & Bartlett Learning.

Black Widow Spiders

• Also known as brown widow spiders and red-legged spiders

• Only three of the five species are actually black.

© photobar/Shutterstock.

Tarantulas

• Bite only when provoked or roughly handled

• When upset, scratches abdomen and flicks hairs onto a person

© Nick Simon/Shutterstock.

Scorpion Stings

• Look like miniature lobsters

• Stings to adults are usually not life threatening.

• Stings to small children are often dangerous.

• http://www.wikihow.com/Kill-a-Scorpion

© David Desoer/Shutterstock.

Embedded Ticks: What to Look For

• No initial pain• Red area around tick• Rash, fever, and chills• Varies from small

bump to extensive swelling and ulcer

Courtesy of James Gathany/CDC.

Marine Animal Injuries

• Most marine animals bite or sting in defense rather than attack.

© AbleStock.

Marine Animals That Sting

• Jellyfish and Portuguese man-of-wars have long tentacles equipped with nematocysts.

Courtesy of NOAA. © Nir Levy/Shutterstock.

Stingrays

• The tail barb of a stingray easily penetrates human skin and can do significant damage.

© Roger Dale Calger/Shutterstock.