Bites and Envenomations

Question 1

Which types of bites should you not apply cold packs or ice to and why?

Answer 1

Snake bites because it can cause more tissue damage.

Question 2

Ice or cold packs can be applied to ________ bites or stings to ______________.

Answer 2

insect; reduce pain and swelling

Question 3

What should your HPI include for Bites and Envenomations? (7)

Answer 3

1) Type of bite/sting 2) Description of creature 3) Time, location, size of bite/sting 4) Previous reaction to bite or sting? 5) Domestic vs. wild 6) Tetanus or rabies risk? 7) Immuno-compromised patient?

Question 4

What signs and symptoms should you be looking for with bites and envenomations? (7)

Answer 4

1) Rash, skin break, wound 2) Pain, soft tissue swelling, redness 3) Blood oozing from site? 4) Evidence of infection? 5) SOB or wheezing? 6) Allergic reaction, hives, itching 7) Hypotension or shock?

Question 5

What are the important parts to your differential diagnosis? (8)

Answer 5

1) Animal bite? 2) Human bite? 3) Snake bite (snake poisonous?) 4) Spider bite (spider poisonous?) 5) Insect bite/sting? 6) Infection risk? 7) Rabies risk? 8) Tetanus risk?

Question 6

What are the 4 parts to the EMT part of this assessment?

Answer 6

1) Initial assessment (general impression, airway, breathing, circulation.) 2) Pulse oximetry and oxygen administration 3) Position of comfort and remove restrictive clothing 4) Immobilize bitten area in a slightly dependent position.

Question 7

What are the 6 part of the Paramedic part of this assessment in addition to the 4 EMT parts?

Answer 7

1) Initial assessment (general impression, airway, breathing, circulation.) 2) Pulse oximetry and oxygen administration 3) Position of comfort and remove restrictive clothing 4) Immobilize bitten area in a slightly dependent position. 5) Cardiac monitor 6) IV establishment in non affected extremity 7) If urticaria, rash, or difficulty breathing present then refer to allergic reaction/anaphylaxis protocol 8) If hypotension or signs and symptoms of shock present then refer to shock protocol 9) Transport promptly 10) Reassess vital signs

Question 8

When should you apply any type of constrictive band or tourniquet as treatment for bite or envenomation?

Answer 8

Only if to control severe hemorrhage.

Question 9

Which bites are worse: animal or human? Why?

Answer 9

Human because of normal mouth bacteria

Question 10

Which type of bites are more likely to become infected and all of which carry the risk for rabies?

Answer 10

Carnivore (and omnivore)

Question 11

Which type of animal bites can progress to infection rapidly due to a bacteria called Pasturella? Where on this animal is the bacteria carried?

Answer 11

Cats; nasal cavity, oral cavity, and on the tonsil region.

Question 12

Poisonous snakes in this area are members of the pit viper family: 1) _____ 2) ______ 3) _______.

Answer 12

eastern diamondback rattlesnake, copperhead, and water moccasin.

Question 13

What snake is this?

Answer 13

Eastern diamondback rattlesnake

Question 14

What snake is this?

Answer 14

Copperhead

Question 15

What snake is this?

Answer 15

Water Moccasin (AKA Cotton mouth)

Question 16

Snake envenomation is generally worse with _______ snakes and in early ________.

Answer 16

Larger; early spring

Question 17

If no pain or swelling is noted then:

Answer 17

envenomation is unlikely

Question 18

Describe the progression of a Black Widow spider bite?

Answer 18

At first they are usually minimally painful but over a few hours muscular pain and severe abdominal pain may develop.

Question 19

Describe the progression of a Brown Recluse Spider bite.

Answer 19

Minimally painful to painless. Little reaction noted initially, but tissue necrosis at the site of the bite normally develops over two to three days.

Question 20

What are the signs and symptoms of infection of the bite or sting wound?

Answer 20

swelling, redness, drainage, fever, red streaks proximal to the wound

Question 21

What are the examples of “immuno-compromised” patients that are at greater risk for infection from bites or stings?

Answer 21

diabetic patients, patients in chemotherapy, patients who have organ transplants, and patients with HIV/AIDS.