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Family Health Magazine
FIRST AID

Bites & Stings
Prevent them if you can – first aid for when you can't

Along with the warm weather, the season for picnics, hiking, dog-walking and gardening has finally arrived. However, fresh-air activities can bring less welcome brushes with nature. Encounters with insects, snakes or even wild animals are all part of enjoying the great outdoors. Preparing for the unexpected can help you keep your peace of mind.

Preventing bites and stings

The best way to prevent being bitten or stung is to avoid animals and insects. Still, this is not always practical. Animals and insects usually only bite or sting when threatened. By giving creatures plenty of room, and not startling them, you are less likely to be bitten or stung. Keep the following in mind as an added precaution.

Insect bites and stings

• Do not use or wear products that attract stinging insects, such as aromatic hair shampoos, and certain perfumes and other scents.
• If you find a nest of stinging insects near your home, have it safely destroyed as soon as possible. Delaying only results in a larger nest with more insects.
• Teach children not to panic when bees or wasps come near them. Panicking makes the insects nervous too. Show kids how to wait calmly for insects to leave, or to gently brush them away.
  Use insect repellent when appropriate, following the package instructions.

Animal bites

• When travelling in the bush, make lots of noise. Animals in your path will hear you coming and get out of your way.
• While camping, use proper precautions for storing food, washing dishes and disposing of food. For more information, check out books on wilderness travel.
• Do not feed wild animals.
• Stay away from any animal that seems unusually friendly or fearless.
• Unless you know them, keep your distance from domestic animals.

Tick bites

• Wear a long-sleeved shirt with buttoned collar and cuffs. Tuck your pants into your socks when walking through grassy or wooded areas.
• After a walk in a grassy or wooded area, check your body for ticks. They are very small and may look like moving freckles.
• If you find one, check very carefully for others.

Snakebite

Snakes do not hunt or attack people – they only bite when they feel threatened. If you are in snake country:

• Learn more about the habits of snakes so you know how to avoid them.
• Never put your hands or feet in a place you cannot see. If climbing rocks, do not reach up and put your hand on a ledge where a snake may be sunning itself. Do not kick under a dead tree to loosen it in case there is a snake underneath. Use a stick instead of your feet.
• If you see a snake, stay away. Remember a snake does not travel very far, so it will probably be in the same area on your return.

First Aid for Bites and Stings

Insect bites and stings

In most people, insect bites or stings cause only painful swelling with redness and itching at the site. However, for those who are severely allergic, being stung can cause a life-threatening allergic reaction.

If someone is stung, immediately ask about any previous allergic reactions to a sting. Also look for the signs of allergic reaction. If you think an allergic reaction is beginning, have the person rest and give appropriate first aid.

• sudden pain
• swelling
• heat
• redness
• itching

First aid measures

• Examine the sting site closely, looking for the stinger that may still be in the skin. If it is there, remove it gently by carefully scraping it and the attached poison sac from the skin. Do not pinch it with tweezers, fingers or anything that may squeeze more poison into the body.
• If there is irritation at the site of the sting, apply ice or a paste of baking soda and water. If the sting is in the mouth, provide a mouthwash made of one teaspoon of baking soda in a glass of water, or give a piece of ice to suck on. If you have one, give an antihistamine such as Diphenhydramine, e.g. Benadryl™.
• If there is swelling in the mouth, get medical help immediately. If there is difficulty breathing, this is an emergency. Call 911 or an ambulance.

Symptoms of allergic reaction

• general itching, rash
• a bump or bumps on the skin that may be white, pink, reddish or blotchy
• generalized swelling – especially of the airway or tongue
• trouble talking or swallowing
• weakness, headache, faintness
• fever
• anxiety
• breathing difficulties that may be severe
• abdominal cramps, vomiting
• Severe allergic reaction

As soon as you realize there is a severe allergic reaction, send for medical help.

• Stop any activity and place the person in the most comfortable position for breathing – usually sitting upright.
• Those who know they are allergic to insect stings often carry prescribed medication, such as EpiPen™ or TwinJect™. If this is the case, help the person use the prescribed medications.
• Stay until medical help arrives. Reassure the person since fear and anxiety make the condition worse.

Animal and human bites

Any bite, whether human or animal, can be serious because it can puncture or tear the skin and carry contaminated saliva into the body. Human bites and the bites of domestic animals are dangerous because of the risk of infection.

Bites from wild animals, such as bats, foxes, skunks, coyotes and raccoons may cause rabies, a disease that can be fatal without prompt medical attention. Always assume any bite from an animal could be infected with rabies, until proven otherwise.

More about rabies

Rabies is a virus that affects the central nervous system. Untreated, it is almost always fatal in humans. Suspect rabies in a domestic animal that is behaving unusually – for instance, a gentle dog or cat that attacks for no reason and is aggressive towards its owner. All attacks by wild animals are suspect. Rabies can be transmitted to anyone who handles a diseased animal or touches a wound infected by the virus.

• Be especially careful when giving first aid to anyone who may have been exposed to rabies or when handling the live or dead animal involved. Wear gloves and wash your hands thoroughly after contact to reduce the risk of infection.
• If the animal can be captured without risk, it should be kept for examination. If the animal must be killed, try to keep the head intact so the brain can be examined for the rabies virus.
• Even if a person has been injured by an animal infected with the virus, rabies can be prevented if medical treatment is given quickly.

First aid measures

• Examine the wound to see if the skin is broken.
• If there is bleeding, apply direct pressure to the wound.
• Wash the wound with antiseptic soap or detergent. Apply a bandage.
• If the skin is broken, see your family doctor as soon as possible.

Leeches

Leeches live in swamps, ponds, lakes and stagnant water. Some feed on the warm blood of animals or humans. A leech makes a tiny cut in the skin and attaches itself to feed on blood. Once it is attached, trying to pull a leech off often does not work. It may tear into smaller parts, making it even harder to remove and increasing the risk of infection.

First aid measures

• Detach the leech by making it let go. Apply salt, heat from an extinguished match head or other source, or a drop of kerosene, turpentine or oil to it. The leech should detach itself from the skin and fall off in one piece. Do not pull or scrape the leech off the skin.
• Clean the area with a paste of baking soda and water. This will also relieve irritation.
• If the site shows any sign of infection during the next week, see a doctor.

Ticks

Ticks are found in abundance throughout the forests in some parts of Canada. They drop from foliage onto animals and humans, biting through the skin and anchoring themselves with barbed mouth parts. A tick sucks blood for many hours and can become quite large. At the end of the meal, it will detach and drop off.

Poison from ticks may be harmful. They sometimes carry disease, such as Lyme disease, that can spread to humans. A tick on the body should be removed. If you find a tick, check your body and clothing thoroughly for others.

First aid measures

• Remove the tick. Grasp it as close as possible to the skin and pull it away with even, steady pressure. Avoid squashing an engorged tick. Infected blood may spurt into your eyes, mouth or a cut on the surface of your skin. If you do not have tweezers, wear gloves or cover your fingers with a plastic bag or tissue paper.
• Clean the area with soap and water and apply an antiseptic to prevent infection. Wash your hands.
• Since ticks transmit disease, consult a doctor. Take the dislodged tick for identification.
• If the site of the bite shows signs of infection, or other symptoms appear within the next week, see a doctor.

Snakebite

Rattlesnakes are the only poisonous snakes found in the wild in Canada. Although varieties of this snake are found in parts of British Columbia, Alberta, Saskatchewan and Ontario, they are not numerous, so snakebite is uncommon.

A rattlesnake’s bite leaves two puncture holes in the skin. Venom is usually, but not always, injected during the bite. If venom is injected, a burning sensation will be felt in the wound. Swelling and discoloration, severe pain, weakness, sweating, nausea, vomiting and chills follow. Breathing may be difficult.

First aid measures

• Make sure there is no danger of a second snakebite to you or the person who has been bitten.
• Have the person rest in a semi-sitting position. Keep the affected limb below the heart. This should slow the spread of venom.
• Flush the bite with soapy water, if available, but do not apply cold compresses or ice.
• Put a constricting band on the limb (see below).
• Splint the limb as you would a broken bone.
• Get the injured person to a doctor as soon as possible.

Constricting Bands

• When a snakebite occurs on a limb, a constricting band should be placed on the limb between the bite and the heart to slow the spread of venom through the body. The best material for a constricting band is soft rubber tubing. However, a narrow triangular bandage, an elastic bandage or even something like a woman’s stocking may be used.
• Place the constricting band 5 to 10 cm (2 to 4 in.) above the wound. Do not put it on a joint or around the head, neck or trunk. You should be able to slip two fingers under the band.
• Loosen the band if you see signs of loss of circulation, such as skin turning blue or becoming very cold.

Snakebite causes swelling. Adjust the constricting band so it does not become too tight as the tissue swells.

Precautions when dealing with snakes and snakebite

• Since most snakes stay within 10 metres (30 feet) of where the bite took place, be careful.
• Do not let a person bitten by a snake walk to medical help if there is any other method of transportation.
• Do not give the person alcohol to drink.
• Do not cut the puncture marks or try to suck out the poison with your mouth.
• If the snake is killed, take it with you for identification but do not touch it directly. Avoid the snake’s head – a dead snake still may have a bite reflex.