Bites And Stings

Question 1

Plants

Answer 1

Plants usually cause contact problems (ingestion with PEDs)

Reactions can be delayed due to bodies first protective mechanism

Reactions can still become fatal

Question 2

Animals

Answer 2

Animals usually go through the protective dermis layers

Reactions / problems occur quicker due to vascular access

Question 3

Plants signs and symptoms of the sympathetic system

Answer 3

Tachycardia

Dilated pupils (mydriasis)

Hot dry skin

Decreased bowel sounds

Altered vision

Abnormal mental status

Some may start as a stimulant and follow with depression and weakness

Question 4

Plants signs and symptoms of parasympathetic system

Answer 4

Bradycardia

Pinpoint pupils (miosis)

Salivation

Hyperactive bowel sounds

Diarrhea

Some may start as a stimulant and follow with depression and weakness

Question 5

Spider bites

Answer 5

Spider bites can cause various problems from local to systemic

Neurotoxin (poisonous to nerves or nerve cells)

Cytotoxic (causing cell death / local tissue necrosis)

Reaction to bites are also directly related to patient size and health

Question 6

For main spiders

Answer 6

Orb-weaver spider

Black widow spider

Thin legged wolf spider

Brown recluse

Question 7

Orb weaver spider

Answer 7

Found in most regions of Alberta

Most sightings during latter part of the summer

Poisonous bite but generally not harmful to humans

Children may react more than healthy adults

Question 8

Orb-weaver spider signs and symptoms

Answer 8

Site swelling

Site redness / pain

Site numbness

Extreme cases include n / v

Question 9

Black widow

Answer 9

Rare in Alberta

Have been found with fruit shipments

Question 10

Black widow signs and symptoms

Answer 10

Spasms

Bites

Muscle rigidity

Intense pain

Headache

Dizziness

Nausea

Vomiting

Edema of the eyelids

Increased sweating and salivation

Question 11

Thin legged wolf spider

Answer 11

Found in grassy regions locations across the province

Don’t make webs but run down prey

Largest spider

Question 12

Good legs wolf spider signs and symptoms

Answer 12

Minor skin tears

Redness / swelling at site

Blackness / necrosis may develop at site

Swollen lymph glands

Signs and symptoms can last up to 10 days

Generally bites of this kind are not fatal

Question 13

Scorpions

Answer 13

It is not deadly

Its sting is relative to that of a bee with similar signs and symptoms and treatment

Question 14

Rattlesnake

Answer 14

Pit viper family

20% of victims died a hundred years ago

Anti-venom available

Bite itself can be serious if not treated, but for a healthy adult a bite is usually not life-threatening

Do not apply ice

Recent studies show that Iceman in fact make the injury worse

Question 15

Snake bite signs and symptoms

Answer 15

A noticeable bite on the skin which may appear as a discolored area with two but occasionally only one puncture mark

Pain and swelling in the area of the bite - may take several hours to develop

Rapid pulse and laboured breathing

Progressive general weakness and paresthesias

Vision problems

Nausea and vomiting

Drowsiness or unconsciousness

Massive edema

Subcutaneous ecchymosis

Shock

Question 16

Bees and wasps

Answer 16

Bees and wasps sting and injector venom

Honey bees are the only ones to leave the stinger behind, due to a barbed stinger

Bumblebees and all wasps (including hornets) can sting numerous times, due to a smooth stinger

Question 17

Bees include

Answer 17

Honey bee

Bumble bee

Question 18

Wasps include

Answer 18

Yellow jacket

Paper wasps

Bald faced Hornet

European hornet

Question 19

Bee stinger removal

Answer 19

Drag a sharp object gently across the skin so it catches the stinger and drags it out

Do not squeeze as this will inject even more venom

Question 20

Mammalian or human bites

Answer 20

Animal bites carry a high risk of infection due to the large presence of bacteria viruses in the mouth

Larger animals when they bite will cause ragged tearing motions which will bleed more than smooth cuts

Question 21

Bite treatments

Answer 21

Clean as best you can

Control deadly bleeding

Bandage appropriately

Question 22

Rabies

Answer 22

Virus that can be spread via animal bites

Incubation. Equals 2 to 16 weeks

Animal carriers include : raccoons, skunks, bats, foxes, and even domesticated animals like cats cattle and dogs

Question 23

Rabies signs and symptoms

Answer 23

Onset of flu like symptoms

Progressive within days to symptoms of cerebral dysfunction, anxiety, confusion, agitation

Progressing to delirium, abnormal behaviour, hallucinations, and insomnia

Question 24

Rabies - the acute period of disease typically ends?

Answer 24

2 to 10 days after

Once clinical signs of rabies appear, the disease is nearly always fatal, and treatment is typically supportive

Question 25

Disease prevention for rabies is entirely?

Answer 25

Prophylactic and include both passive antibody (immune globulin) and vaccine

Question 26

Bites and stings treatment

Answer 26

If practical, attempt to collect the insects / reptile for identification Call poison control center if required Keep limb and mobilize to minimize the spread of toxins Remove the stinger by scraping it out of the skin Apply cold pack to reduce swelling / circulation (except pit viper) Maintain and monitor and open airway Place affected limb lower than heart Draw lines on patient the show if any progression ECG monitoring Initiate IV in opposite limb Transport Keep patient calm to decrease excitation and blood flow

Question 27

Hypersensitivity reactions

Answer 27

An altered pathologic / immunologic reaction to an antigen after re-exposure Repeated exposures causes increased reactions generally Children can grow out of allergies

Question 28

Anaphylactic versus allergies

Answer 28

Allergic reactions are not anaphylactic reactions but anaphylactic reactions are allergic reactions Difference is severity and systems affected

Question 29

Histamine response

Answer 29

Histamine H1 is the big problem Histamine usually protects the body and signals defensive response by the body - attacks foreign bodies - helps healing process

Question 30

Histamine H1

Answer 30

Stored in my cells Released when marker on cell is activated -immunoglobulin E (IgE) Ige become sensitized to wrong substance and becomes activated incorrectly on second exposure

Question 31

Histamine H1 causes?

Answer 31

H1 causes third spacing and vasodilation swelling is body's natural response to injury healing, except in this case, response outweighs the wound Loosens Gap junctions between cells Causes out rush of -phages and -phil's Itching stimulus and epidermis Causes secondary smooth muscle constriction in bronchial and GI tract

Question 32

Allergic reactions

Answer 32

Allergic reactions are local responses to an antigen Generally affect only one or two systems Not life-threatening Body will with time correct itself Usually easily controlled with over the counter drugs

Question 33

Allergic reactions signs and symptoms

Answer 33

Conjunctivitis Rhinitis Angioedema Urticaria / pruritus Contact dermatitis

Question 34

Allergic reaction treatments

Answer 34

Street signs and symptoms at cordingly within scope ALS treatment - diphenhydramine or Benadryl Managed with drugs that compete with histamine at the receptor site

Question 35

Anaphylaxis

Answer 35

Sensitization is the same as allergic reactions Ige is stimulated on second exposure causing mast cell degranulation, just like allergic reaction Histamine (short acting) and leukotrine (longer acting) release same as allergic reaction, except reaction is way stronger - profound vasodilation from increased vascular permeability - constriction / spasming of bronchial / GI smooth tissue - swelling of soft tissue in Airways

Question 36

Anaphylaxis exposure 4

Answer 36

Absorption Inhalation Ingestion Injection

Question 37

Anaphylaxis

Answer 37

Comes from Greek and means against or opposite of protection Involves two or more systems with one typically being respiratory Potentially deadly condition / reaction Almost any substance can cause anaphylaxis

Question 38

Anaphylaxis accounts for how many death per year

Answer 38

Accounts for 400 to 800 deaths per year with a mortality rate of 3%

Question 39

Anaphylaxis signs and symptoms upper airway

Answer 39

Hoarseness Strider Laryngeal epiglottic edema Rhinorrhea

Question 40

Anaphylaxis signs and symptoms lower airway

Answer 40

Bronchospasm Increase mucus production Accessory muscle use Wheezing Decreased breath sounds

Question 41

Anaphylaxis signs and symptoms cardiovascular system

Answer 41

Tachycardia Hypotension Dysrhythmias Chest tightness

Question 42

Anaphylaxis signs and symptoms gastrointestinal system

Answer 42

Nausea vomiting Abdominal cramps Diarrhea

Question 43

Anaphylaxis signs of symptoms cutaneous system

Answer 43

Angioedema / edema You treat carrier Pruritus Erythema Tearing of the eyes

Question 44

Anaphylaxis signs and symptoms neurological symptoms

Answer 44

Anxiety Dizziness Syncope Weakness Headache Seizure Coma

Question 45

Anaphylaxis treatment

Answer 45

Position of comfort (usually tripod do to SOB) with legs elevated O2 via NRB at 15L/min (ventilatory assistance PRN) V/S q 5 minutes Epinephrine 1:1000 IM or SC 0.3-0.5mg - may be repeated after 5 10 minutes if no improvement - Note: slower absorption with SC dose due to shock Ventolin 2.5-5.0mg and atrovent 250-500mcg via NEB (may not be effective with poor ventilation). Max = 3 doses Initiate large-bore IV x 2 Fluid bolus PRN 20cc/kg x 2 max Rapid transport to hospital or ALS intercept

Question 46

Anaphylaxis criteria

Answer 46

Exposure to a known or suspected allergen with a sudden onset of illness and at least 1 of the following: - sudden respiratory signs and symptoms - sudden systolic BP less than 90 mmHg are symptoms of end organ dysfunction OR Exposure to a known or suspected allergen with a sudden onset of illness and BOTH of the following: - sudden skin are mucosal sign and symptoms - sudden gastrointestinal symptoms