July 22, 2009
Most insect bites and stings do not require medical treatment. As I am writing this article my legs are covered in mosquito bites that itch, but are not dangerous. There are however times when insect bites and stings can be life threatening.
Anaphylaxis is a life-threatening allergic reaction that requires emergency care. Reactions can affect the whole body and can occur quickly, usually within a few minutes. Anyone exhibiting signs of anaphylaxis is in danger as severe reactions can be fatal if untreated.
Warning signs include trouble breathing, wheezing, shortness of breath, swelling anywhere on the face, tightness in the throat, weakness and/or dizziness, the patient’s skin turns blue, fever, hives, painful joints, abdominal pain, shock, nausea, vomiting, intestinal cramps, diarrhea, confusion, rapid heartbeat, swelling larger than 2 inches in diameter at the site and swollen glands. If you see any of these signs, you must radio for help.
Two types of spiders have bites that can be deadly: the black widow and the brown recluse. If someone is bitten by either of these you should call for medical help and closely monitor the patient’s condition. If you can, safely bring the insect to the hospital for identification. This can assist in efforts to treat the patient.
Until help arrives, there are several emergency first-aid actions you can perform for severe reactions from bites and stings.
Check the victim’s airway. With your head next to the victim’s mouth look at his/her chest for movement, listen for breathing and feel for breath on your face. If the person is not breathing, radio for help and begin CPR.
If the person is breathing, keep him/her calm.
Remove anything that could be restrictive if the bite area swells, including rings, bracelets, watches, necklaces and other jewelry.
Loosen tight-fitting clothing and cover the person with a blanket.
If the problem is severe, you may need to use the epi-pen. Typically, people who have severe allergic reactions are prescribed epi-pens. The ship’s medical kit should also have epinephrine. The epi-pen contains a spring-loaded needle that will automatically inject the medication into the patient when pressed firmly against his/her thigh.
It should be held into place for about 10 seconds while the epinephrine is delivered to the body. Please note that this medication is to be injected into the muscle on the patient’s thigh. Giving this medication intravenously is not recommended as it can be deadly.
An epi-pen has a typical shelf life of about 20 months. Check the dates of epi-pens regularly.
After administering the medication, patients are advised to seek immediate medical attention.
For bite victims who are not having a severe reaction, perform these standard first-aid actions:
Move the victim to a safe area to avoid further stings or bites.
If you can see it, remove the stinger by scraping it away with a credit card, fingernail or the back of a knife. Do not use tweezers as this may squeeze the venom sac, injecting more venom into the victim’s body
Wash the bite or sting site thoroughly with soap and water.
Place ice on the bite/sting site for 10-15 minutes, remove for the same amount of time, and repeat. Do not apply ice directly to the skin as this may damage the skin. A thin towel between the skin and the ice works well. The ice will reduce pain and swelling.
If available, apply anti-itch hydrocortisone cream that will reduce itching.
With medical direction, offer an antihistamine containing diphenhydramine (Benadryl, Tylenol Severe Allergy) or chlorpheniramine maleate (Chlor-Trimeton, Actifed).
Never apply a tourniquet to someone who has been bitten or stung by an insect and never give the person stimulants, aspirin, pain medication or anything to eat or drink unless instructed to do so by a doctor. When in doubt, always seek professional medical advice and treatment. Remember, an ounce of prevention is better than a pound of cure.
Keith Murray, a former Florida firefighter EMT, is the owner of The CPR School, a CPR, AED and first-aid training company that provides onboard training for yacht captains and crew. Contact him at +1-561-762-0500 or keith@theCPRschool.com. Comments on this column are welcome at editorial@the-triton.com.
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