Bites and Stings
(Insect, marine, and snake)
Consequences of venom from poisonous insects, spiders, marine life, and snakes range from minor to life-threatening; anyone who spends time outdoors should be aware of the hazards.
Bee stings. Most stings from flying insects in the Hymenoplera family -- bees, wasps, hornets,and yellow jackets -- are more of a nuisance than a health hazard. However, certain proteins excreted in their venom can cause potentially fatal allergic reactions in people who are hypersensitive to them.
Spiders and scorpions. Spiders to be concerned about are the black widow and brown recluse. Only the female black widow bites. Be especially wary if she is guarding an egg mass. Brown recluse, or violin, spiders hide in dark, out-of-the-way places, including the folds of blankets or clothing, and will bite if disturbed.
There are about 70 species of scorpions in North America. Their stings are painful, but not especially dangerous, unlike those of their cousins in tropical countries.
Sea creatures. Although bites and stings from marine life in coastal waters can be very painful, most are not poisonous. The primary exceptions are stingrays, the Portuguese man-of-war, and some types of jellyfish.
Snakes. About 45,000 Americans are bitten by snakes every year. Of this number, about 9,000 experience snake venom poisoning, but only about 15 deaths occur as a result.
Two types of poisonous snakes are indigenous to the United States, pit vipers and coral snakes. A pit viper, which includes the rattlesnake, copperhead, and cottonmouth (also called water moccasin), has a triangular head with a pit between the eyes and slit-like pupils. The coral snake, a variety of cobra, has a rounded head and black rings bordered at both ends by bands of yellow.
All other U.S. snakes, which also have round heads, are not poisonous. Their bites, however, can cause a painful infection if they go untreated.
Diagnostic Studies and Procedures
Diagnostic studies are not required to assess bites and stings. Instead, knowledge of what caused the bite and development of these symptoms indicate whether or not a bite is serious.
After a bee sting. Signs of a hypersensitive reaction include severe swelling beyond the site of the bite, hives or other rash, severe itching, wheezing or other breathing problems, weakness or dizziness, stomach cramps, nausea and vomiting, severe anxiety, and possible loss of consciousness.
After a bile by a crawling insect. General signs of poisoning include a painful stinging or burning sensation when bitten, redness and swelling at the site of the bite, and worsening pain over the course of several hours. At the spot where a brown recluse spider has bitten, a blister develops and, within a day or two, chills, fever, nausea, vomiting, and weakness may occur, possibly followed by tissue death advancing over a wider area.
A bite by a black widow spider causes profuse sweating, stomach cramps, nausea, vomiting, tightness in the chest, and difficulty in breathing.
The area around a scorpion sting becomes numb and tingly; nausea, vomiting, muscle spasms (especially around the site of the bite) and sometimes convulsions and shock.
After a marine bite or sting. Stingray venom produces immediate pain, which spreads rapidly over the next 90 minutes; this is followed by dizziness, weakness, nausea and vomiting, diarrhea, cramps, sweating, anxiety, lymphs node pain and, in the worst cases, difficulty in breathing and arrhythmias. Jellyfish or Portuguese man-of-war venom causes pain, itching, and long, red wheals on the skin, followed by weakness, nausea, headache, muscle pain and spasms, sweating, tearing, difficulty breathing, and chest pain. In some cases, shock may develop.
After a poisonous snake bite. If venom has been injected, there is usually pain and swelling, followed by skin discoloration. Severe poisoning is marked by general weakness or drowsiness, rapid pulse, increased salivation and sweating, breathing difficulty, blurred or dimming vision, swollen eyelids, slurred speech, nausea and vomiting, convulsions, and shock, possibly advancing to coma and death.
Medical Treatments
If the person is hypersensitive to bee venom, a sting requires an immediate injection with adrenaline, or epinephrine, which can prevent anaphylactic shock. An antihistamine also may be given. If avoiding bees is difficult, desensitization may be recommended. This involves weekly injections of diluted bee venom for a year or more to permit the body to build up resistance.
Treatment for poisonous spider or scorpion bites depends on the creature involved and the severity of symptoms. Sometimes local therapy to ease discomfort is all that is needed. In other cases, treatment may require antivenin injections, hospitalization, and even life support until the crisis is past. Steroid injections may be given if the wound from a brown recluse continues to expand after the first 12 to 24 hours.
A sting from a marine animal may require a tetanus shot, antibiotic therapy, and, depending on the wound, removal of the stinger and surgical closure. Painkillers and topical lotions containing an antihistamine, anesthetic, and corticosteroids also may be prescribed. In more serious cases, especially if shock occurs, hospitalization for intravenous therapy and oxygen support may be necessary.
Immediate treatment for a poisonous snake bite usually involves extracting the venom by suction. Some doctors also cut open the wound and excise a block of tissue around the bite. If symptoms are severe, antivenin may be given intravenously for several hours or, less commonly, by intramuscular injection. However, antivenin itself could cause an anaphylactic reaction, so sensitivity must be tested first by exposure to a diluted solution of it. Even so, careful monitoring is essential after giving snake antivenin. A tetanus shot, antibiotics, and a painkilling medication will also be administered when indicated.
If shock develops following any type of bite or sting, treatment will probably include blood transfusions, intravenous fluids, and possibly oxygen and respirator support. During recuperation, a large wound will be cleaned of dead tissue. The wound may also be enclosed in a plastic bag and exposed to high concentrations of oxygen (oxygen therapy) to help speed healing.
Alternative Therapies
If you are bitten by a venomous creature, immediate medical attention is called for. Alternative therapies may provide relief, however, for lesser bites and stings. These can also speed healing of severe bites and stings when used as a supplement to medical treatment.
Herbal Medicine. Herbalists praise slippery elm, extracted from the inner bark of the red elm tree, for its healing properties. Some recommend mixing the powder with water and making a poultice to treat uncomplicated bites.
For more extensive wounds, an herbalist may use a poultice made with ground comfrey root or crushed burdock root, place it over the wound, and cover it with a bandage. A poultice should be changed daily and before it is reapplied, the wound should be cleansed thoroughly with soap and sterile water, or with hydrogen peroxide to help prevent an infection.
Chamomile or witch hazel extracts can be applied directly to minor bites and stings to promote healing.
Native Americans use the leaves and roots of the echinacea plant to treat snake and insect bites and a poultice of yarrow flowers to treat wounds.
There is some evidence that eating raw garlic may help prevent infection.
Naturopathy. Application of a fresh-cut slice of raw onion to a bee sting is one of several natural methods to alleviate the swelling and pain. Another is to smear it with honey and then apply an ice pack. The juice squeezed from plantain leaves that have been bruised and heated until they wilt is said to relieve many bee and insect stings. Also, the leaves from a lesser known member of the plantain family, the psyllium plant, have long been used to soothe minor bites and stings.
Self-Treatment
Most insect bites are not harmful; they produce only minor pain and irritation, which often abates when you apply ice followed by calamine lotion. You can also ease the itching of mosquito and other bites by applying a poultice of cornstarch or baking soda and fresh lemon juice. If itching persists, try a cool compress soaked in Burows solution, which is available without a prescription at most pharmacies.
Immediate first aid is important for more serious bites and stings, especially if there are any symptoms of anaphylactic shock or venom poisoning.
Do not use ice on a snake bite. Wash the wound with soap and water and apply a simple bandage. If you are bitten on an arm or leg, remove rings, shoes, or other items that may become constrictive if swelling occurs. Call your doctor for advice on whether a tetanus shot and antibiotics are advisable.
If there is the slightest possibility that a snake bite is poisonous, head for a hospital emergency room immediately if you will be able to reach it within 30 minutes. If transportation will take longer, start first aid immediately. Try to identify the type of snake involved so you can report it to health-care personnel.
Other Types of Bites
Bite wounds from both humans and animals are among the most common injuries seen in hospital emergency rooms. Cat bites occur more often than dog bites -- and, according to the American Red Cross, are more likely to cause infection, because cats' mouths harbor a greater variety of bacteria. A severe dog bite, however, causes more extensive tissue damage.
Human bites are as serious as those of most animals because they, too, commonly cause infection. Therefore, I even a bite that seems minor should receive medical attention and antibiotics to prevent complications.
For both human and animal bites, i first aid consists of cleaning the wound with soap and warm water and then applying an antiseptic such as hydrogen peroxide. See a doctor for any deep puncture wound.