Bites and Stings: Complications and Treatment

Question 1

Beens and wasps

Answer 1

Complication: anaphylaxis
Management: antihistamines and steroids; IM epi if anaphylaxis occurs

Question 2

Spiders

Answer 2

Complications: necrosis, hypocalcemia

Management: antivenom; surgical resection and skin grafts for severe necrosis

Question 3

Scorpion stings

Answer 3

Complications: CN dysfunction, excessive motor activity, respiratory compromise

Management: supportive w/ benzos and analgesics
-atropine for hypersalivation and respiratory distress

Question 4

Snake bites

Answer 4

Complication: venom poisoning

Management: antivenom

• elevate affected limb above heart
• compression bands help

Question 5

Dog and cat bites

Answer 5

Complications: infection and rabies/tetanus

Management: amox/clavulanate for puncture wounds, bites to hand or feet, and in high-risk or immunocompromised patients

Question 6

Humans

Answer 6

Treat with amox/clavulinate

Question 7

Rodents

Answer 7

Management: local wound care

Question 8

Rabies precautions

Answer 8

From dogs, cats, ferrets, skunks, raccoons, bats

Ppx:

• animal displays signs: 1 dose of rabies IG and 4 doses of rabies vaccine over 14 days if pt has not been vaccinated
• if previously vaccinated, they don’t need Ig; only 2 doses of vaccine

Question 9

Tetanus precautions

Answer 9

10 years ago for a minor wound OR > 5 years for a major wound: administer tetanus toxoid
Tetanus IG is only needed if wound is major/dirty and patient has had 3 or less lifetime toxoids