the nose, mouth, and throat. These substances includeacids, alkalies, phenols, and some chemical warfareagents. Direct contact with these substances will causeinflammation or chemical burns in the affected areas.Consult the “Chemical Burns” section of chapter 4 andthe “Chemical Agents” section of chapter 8 of thismanual for treatment.INJECTED POISONS ANDENVENOMATIONSInjection of venom by stings and bites fromvarious insects and arthropods, while not normallylife-threatening, can cause acute allergic reaction thatcan be fatal. Poisons may also be injected by snakesand marine animals.Bee, Wasp, and Fire Ant StingsStings from bees, wasps, and ants account for morepoisonings than stings from any other insect group.Fortunately, they rarely result in death. The vastmajority of stings cause a minor local reaction at theinjection site, with pain, redness, itching, and swelling.These symptoms usually fade after a short time. Asmall percentage of these stings can cause an allergicvictim severe anaphylactic reactions, presenting withitching, swelling, weakness, headache, difficultybreathing, and abdominal cramps. Shock may followquickly, and death may occur.The following first aid measures are recommendedfor all but minor, local reactions to bites or stings:1. Closely monitor vital signs (and the wholepatient), and remove all rings, bracelets, andwatches.2. Remove stingers without squeezing additionalvenom (remaining in poison sacs attached tostingers) into the victim. To do this, scrape alongthe skin with a dull knife (as if you were shavingthe person). The dull blade will catch the stingerand pull it out.3. Place an ice cube or analgesic-corticosteroidcream or lotion over the wound site to relievepain. Do NOT use “tobacco juice,” saliva, orother concoctions.4. For severe allergic reactions (generalizeditching or swelling, breathing difficulty, feelingfaint or clammy, unstable pulse or bloodpressure), immediately give the victim asubcutaneous injection of 1:1000 aqueoussolution of epinephrine. Dosage is 0.5 cc foradults and ranges from 0.1 to 0.3 cc for children.5. Patients with severe allergic reactions should beevacuated immediately to a medical facility.Scorpion StingsAbout 40 species of scorpions (fig. 5-2) exist inAmerica.Centruroides exilicauda may cause severeeffects. Most dangerous species are found from NorthAfrica to India. Scorpion stings vary in severity,depending on the species of the scorpion and theamount of poison actually injected. They cause severepain in the affected area.Mild reactions may include local swelling, skindiscoloration, swollen lymph nodes near the sting area,itching, paresthesias (“pins and needles,” numbness),and even nausea and vomiting. The duration ofsymptoms is less than 24 hours.The following first aid treatment should be givenfor scorpion stings:1. Place ice over the sting site (cool the area for upto 2 hours). Do NOT use tobacco juice, saliva,or other concoctions.2. Elevate the affected limb to approximately heartlevel.3. Give acetaminophen for minor pain.4. Calcium gluconate, 10 ml of 10 percentsolution, may be given intravenously to relievemuscle spasms.5. Valium may be used to control excitability andconvulsions.6. An antivenom is available for severe bites byCentruroides exilicauda(also called “barkscorpion,” it is the scorpion found in Mexicoand the American southwest). It is availablefrom the Antivenom Production Laboratory,Arizona State University, Tempe, Arizona85281, phone (602) 965-6443 or (602)965-1457, and from Poison Control in Phoenix,phone (602) 253-3334.CAUTION:Morphine and meperidinehydrochloride may worsen the respiratorydepression from the venom ofCentruroides exilicauda.5-9
Integrated Publishing, Inc. - A (SDVOSB) Service Disabled Veteran Owned Small Business