Tuesday, July 31, 2012

Other Types of Envenomation Injuries

            In a prior post we examined the envenomation injury most of us fear most.......snakebite.
Should you need to refer to this post, it can be found at:


The same "Extractor" from the prior post, which can be so helpful in snakebites, can also be invaluable for insect and arachnid bites, whenever gentle and steady venom extraction would be helpful. Again, the larger amount of venom you can extract from your patient, without creating furthur injury, the better off your patient will be.

              Wasp, hornet and beestings are common injuries, but can occasionally be very dangerous particularly to those who are sensitive to the venom of these insects.  Anyone who is known to be beesting or insect sting allergic, needs to have their primary physician or allergist issue them a prescription for an Epi-Pen or Epi-Pen Jr.   An Epi-Pen is an automatic injector of epinephrine which can save a life of a person who is allergic to certain stings.  Even a child can use one.   Sometimes an allergist will dispense an epinephrine vial and tuberculin syringe for emergency epinephrine treatment for some families or individuals.

            It IS possible for anyone, even those who were never allergic to a certain sting before to develop an anaphylactic reaction to one if stung at a future time.

This information comes from:    http://www.medicinenet.com/insect_sting_allergies/article.htm

Systemic (or body-wide) reactions are allergic responses and occur in people who have developed antibodies against the insect venom from a prior exposure. It is estimated that between 0.3%-3% of stings trigger a systemic allergic reaction. The allergic reaction to an insect sting varies from person to person. Symptoms of an allergic reaction can include itching, hives, flushing of the skin, tingling or itching inside the mouth, and nausea or vomiting. The most serious allergic reaction is called anaphylaxis, which can be fatal. Difficulty breathing, swallowing, hoarseness, swelling of the tongue, dizziness, and fainting are signs of a severe allergic reaction. These types of reactions usually occur within minutes of the sting but have been known to be delayed for up to 24 hours. Prompt treatment is essential, and emergency help is often needed.

Although you must treat wasp, hornet or beestings, if there is difficulty breathing or signs and symptoms of an anaphylactic reaction as outlined above, by either immediately epinephrine injection, and then transport to a hospital, most stings are painful annoyances and can be treated at home.

          Following a beesting, wasp or hornet sting, the possibility exists that a stinger will remain in the wound. Remove it least traumatically, as soon as possible by using a credit card to snag it, and pull it out and away from the wound.        People with milder reactions can apply baking soda as a paste initially, and take a diphenhydramine capsule,  tradename Benadryl, (as per package direction for age and weight, and please use the liquid or chewables for a child, with the correct dose for weight as stated on the specific box you are using.)
          I don't usually need to take a Benadryl, and I usually keep and apply a Diphenhydramine clear liquid, with a cotton ball, after initially using a baking soda paste, and a number of times that first day I repeat the Benadryl liquid via cottonball to help to limit swelling and redness and to promote comfort.

          Although they do not normally, any wasp, hornet or beesting can become infected.  If this appears to have happened, please see your doctor.     Signs of an infected sting site would be painful redness, a yellow purulent head,  fever or even red lines traveling toward the heart from the initial sting itself.  Pay close attention to each wasp, hornet or beesting because we never know when a person who was never allergic in the past, may become allergic to the sting, for the first time.

American dog tick  (Photo: hyg.ipm.illinois.edu )

Ticks and tick bite treatment and concerns are covered in our  prior posts :




The brown recluse spider  (Photo: brown-recluse.com )

Information with detail on spider bites as envenomation injuries are found at:




 Photo: http://www.prlog.org )

Mosquito bites:

        Mosquito bites are not simply an annoyance, or even just a source of secondary infection following itching afterward.  They too can be a hazard.    Malaria, West Nile Virus , Dengue Fever and likely other illnesses can be contracted through mosquito bites.   Experts tell us that HIV-AIDS cannot be contracted through mosquitoes.

This flash presentation discusses why HIV-AIDS  transmission through mosquitoes is highly unlikely if not nearly impossible.


       However, we should do all we can to avoid mosquito bites to avoid contracting any number of other diseases.  The first thing we should do is avoid standing water on our properties, by emptying any containers we can. We can use integrated pest management or chemical means to decrease the possibility of mosquitoes breeding on our properties.  We can also use mosquito repellants when needed.  We can use mosquito netting especially when sleeping in the great outdoors. 
         If we know we are bitten by a mosquito, we can also use the extractor, but the problem often becomes not knowing that we were bitten until some time later when we have the obvious bite.  Diphenhydramine (Benadryl) gel with a cotton call applied multiple times daily in the acute phase of mosquito bites can promote comfort and help to prevent scratching.  Also, the use of your favorite antiseptic is a good idea, as infection is always a potential, if not a likelihood here.

         If you were to develop a high fever or a severe headache within 12 hours or more following a mosquito bite, you need to see a physician.



        Try to stay safe out there !

Sunday, July 29, 2012

The Extractor and the Initial Treatment of Snakebites

This is the outer packaging of "The Extractor".   This can be found on internet sources, and in outdoor supply stores such as Dick's Sporting Goods, REI, Cabela's and many others.
             Recently, I have been receiving questions on how to treat snake bites and other envenomation injuries.  Interestingly, there is a lot of misinformation out there, and a lot of outdated and archaic treatment information is still out there.

              With regard to snake bites, experts agree first on what not to do:


What Not To Do

Though U.S. medical professionals may not agree on every aspect of what to do for snakebite first aid, they are nearly unanimous in their views of what not to do. Among their recommendations:
  • No ice or any other type of cooling on the bite. Research has shown this to be potentially harmful. The same applies for  hot  packs.
  • No tourniquets. This cuts blood flow completely and may result in loss of the affected limb.
  • No electric shock. This method is under study and has yet to be proven effective. It could harm the victim.
  • No incisions in the wound. Such measures have not been proven useful and may cause further injury.
  • Do not eat or drink anything unless advised by medical sources.
  • Do not engage in strenuous physical activity.
  • Do not drink any alcohol or use any medication.
  • Do not apply oral (mouth) suction to bite.
  • Do not remove dressings/elastic wraps until arrival at hospital and antivenom (more correctly, antivenin) is ready and available.
  • Do not waste time or take any risks trying to kill or catch (to bring in) the snake responsible for the bite. (Although a quickly snapped picture with a cellphone might be helpful)
    (This data is found at:    http://arachnophiliac.info/burrow/snakebite_advice.htm)

The ideal treatment is to wash the wound with soap and water,  immobilize the wound keeping it lower than the heart, keep your patient calm and transport to a hospital immediately.

  • If a victim is unable to reach medical care within 30 minutes, a bandage, wrapped two to four inches above the bite, may help slow venom. The bandage should not cut off blood flow from a vein or artery. A good rule of thumb is to make the band loose enough that a finger can slip under it. The bandage should be a crepe or elastic bandage and should be wrapped as you would for a sprain.
  • A suction device*  may be placed over the bite to help draw venom out of the wound without making cuts. Suction instruments often are included in commercial snakebite kits.

    * My own personal recommendation is to have the Extractor brand Complete Bite and Sting Kit on hand.  This is the only device marketed which has been proven to extract venom, and the more venom you extract without skin and regional damage to the patient, the better off you are.

After purchasing one or two Extractors, one for the house, and one for your evacuation kit, you should open it and familiarize yourself with the articles in the box and the procedure for its use.

                 The extractor is beneficial because when applied as directed, it exerts a gentle pulling action which helps to drain venom, WITHOUT creating additional cuts or injuries which will furthur damage the skin, and can lead to infection. It is essential that you open the package, assemble the item, and understand its use prior to an envenomation injury.

           Some hospitals have a variety of antivenins available, but most do not.  They often have cooperative arrangements in which one would stock the antivenin for one type of bite, and another hospital will stock one for another.  When they are needed, they will send over the needed antivenin to the other hospital via courier.
Because snakebite injuries are not common, they may not be very speedy about the actions which need to be taken.

This is information on different types of antivenin.  Most types are fairly expensive and do expire, and this is why hospitals tend to cooperate with one another, rather than buy them all.


(Photo: oakent.com )

Important References:






Here in Virginia, we have a variety of snakes.  The venomous snakes of importance are

1.)  Northern Copperhead     http://www.virginiaherpetologicalsociety.com/reptiles/snakes/northern-copperhead/northern_copperhead.htm

2.)  Eastern Cottonmouth    http://www.virginiaherpetologicalsociety.com/reptiles/snakes/eastern-cottonmouth/eastern_cottonmouth.htm

  3.)  Timber rattlesnake     http://www.virginiaherpetologicalsociety.com/reptiles/snakes/timber-rattlesnake/timber_rattlesnake1.htm

Venom information:


 This chart is the work of :  The Virginia Herpetological Society   and may be found at:


Crotalus horridus horridus (Timber Rattlesnake)

Fall Update and 2011 Timber Rattlesnake Summary
Timber Rattlesnake - Tier IV, Southeastern populations - Tier II


        On our farm, copperheads are common, and they are one of the few things we actually kill here.  Cottonmouth are said to be possible here, though we have never seen one, and we have yet to see a Timber rattlesnake here, although this is why we never lie or sit on the grass, and why we do not walk around here in sandals.  Despite this possibility, most of the snakes here, I would not characterize as harmless, because a bite can cause a serious infection, but I would characterize them as non-venomous.  All snake bites should be seen by a physician. 

      The non-venomous snakes which are found in Virginia are:

This chart is the work of:    The Virginia Herpetological Society and can be found:


nringneck1.jpg (55286 bytes)
sringneck1.jpg (92940 bytes)
Black Kingsnake (Lampropeltis glr.jpg (65969 bytes)
Pantherophis alleghaniensis (Eastern Ratsnake)
(formerly Elaphe obsoleta obsoleta (Black Ratsnake)
npine1.jpg (62454 bytes)
Northern red-bellied snake (Storeria occipitomaculata occipitomaculata)lr.jpg (93918 bytes)

          It is really important to know what types of snakes are possible where you are, and what types of snakes are the most common.  Snakes don't hunt us down with an eye to killing us.  We simply infringe upon their areas sometimes in the course of maintaining or enjoying our own properties, or sometimes they find their way into a place where we are more likely to encounter them, like a woodpile, deck steps, a driveway, or toolsheds, or even rockpiles, or an old well.

These are listing of venomous snakes in each of the United States:


These are listings of  snakes in Canada, including one which is venomous and found in some regions:


Please become familiar with the snakes where you reside.

Readers are encouraged to obtain competent medical device for treatment of all envenomation injuries ESPECIALLY SNAKEBITES as quickly as possible.  This posting is designed to provide starting points for first aid alone, and not complete treatment.  You should familiarize yourself with first aid treatment of envenomation injuries BEFORE they occur.

We will discuss other types of envenomation injuries and their first aid treatment in another post.