Translations:AY Honors/First Aid/Answer Key/83/en

Animal bites

A special kind of infection that must be guarded against in case of animal bites is rabies (sometimes called “hydrophobia”). This disease is caused by a virus that is present in the saliva of infected animals. The disease occurs most commonly in wild animals, but it has been found in domestic animals and household pets. In fact, it is probable that all mammals are susceptible to it. The virus that causes rabies is ordinarily transmitted by a bite, but it can be transmitted by the saliva of an infected animal coming in contact with a fresh wound or with the thin mucous membrane of the lips or nose. The virus does not penetrate normal unbroken skin. If the skin is broken, DO NOT attempt wound closure.

If rabies develops in man, it is usually fatal. A preventive treatment is available and it is very effective, but only if it is started shortly after the bite. Since the vaccine can be obtained only at a medical treatment facility, any person bitten by an animal must be transferred quickly to the nearest treatment facility for evaluation, along with a complete report of the circumstances surrounding the incident. Remember, prevention is of utmost importance. Immediate local treatment of the wound should be given. Wash the wound and the surrounding area carefully, using sterile gauze, soap, and sterile water. Use sterile gauze to dry the wound, and then cover the wound with a sterile dressing. DO NOT use any chemical disinfectant. All of the animal’s saliva must be removed from the victim’s skin to prevent further contamination of the wound. CAUTION: DO NOT allow the animal’s saliva to come in contact with open sores or cuts on your hands. When a person has been bitten by an animal, every effort must be made to catch the animal and to keep it confined for a minimum of 8 to 10 days. DO NOT kill it if there is any possible chance of catching it alive. The symptoms of rabies are not always present in the animal at the time the bite occurs, but the saliva may nevertheless contain the rabies virus. It is essential, therefore, that the animal is kept under observation until a diagnosis can be made. The rabies treatment is given if the animal develops any definite symptoms, if it dies during the observation period, or if for any reason the animal cannot be kept under observation. Remember that any animal bite is dangerous and MUST be evaluated at a treatment facility.

Snake bite

First aid

Snakebite first aid recommendations vary, in part because different snakes have different types of venom. Some have little local effect, but life-threatening systemic effects, in which case containing the venom in the region of the bite by pressure immobilization is highly desirable. Other venoms instigate localized tissue damage around the bitten area, and immobilization may increase the severity of the damage in this area, but also reduce the total area affected; whether this trade-off is desirable remains a point of controversy.

Because snakes vary from one country to another, first aid methods also vary. As always, this article is not a legitimate substitute for professional medical advice. Readers are strongly advised to obtain guidelines from a reputable first aid organization in their own region, and to be wary of homegrown or anecdotal remedies.

However, most first aid guidelines agree on the following:

1. Protect the patient (and others, including yourself) from further bites. While identifying the species is desirable in certain regions, do not risk further bites or delay proper medical treatment by attempting to capture or kill the snake. If the snake has not already fled, carefully remove the victim from the immediate area. If possible, take a photograph of the snake (many cell phones are equipped with cameras). If you do not know what type of snake it is, someone else might be able to identify it from the photo. A poor photo is better than no photo.
2. Keep the victim calm. Acute stress reaction increases blood flow and endangers the patient. Keep people near the patient calm. Panic is infectious and compromises judgment.
3. Call for help to arrange for transport to the nearest hospital emergency room, where antivenin for snakes common to the area will often be available.
4. Make sure to keep the bitten limb in a functional position and below the victim's heart level so as to minimize blood returning to the heart and other organs of the body.
5. Do not give the patient anything to eat or drink. This is especially important with consumable alcohol, a known vasodilator which will speed up the absorption of venom. Do not administer stimulants or pain medications to the victim, unless specifically directed to do so by a physician.
6. Remove any items or clothing which may constrict the bitten limb if it swells (rings, bracelets, watches, footwear, etc.)
7. Keep the victim as still as possible.
8. Do not incise the bitten site.

Many organizations, including the American Medical Association and American Red Cross, recommend washing the bite with soap and water. However, do not attempt to clean the area with any type of chemical. Australian recommendations for snake bite treatment strongly recommend against cleaning the wound. Traces of venom left on the skin/bandages from the strike can be used in combination with a snake bite identification kit to identify the species of snake. This speeds determination of which antivenin to administer in the emergency room.

Insect bites

Though ticks and leeches are not technically insects, we will deal with them here as if they are. Most of the time insect bites and stings will not require first aid. However, you should be aware that there are many insect-borne diseases including Lyme's disease, Rocky Mountain spotted fever, malaria, yellow fever, bubonic plague, etc. Be on the alert for any sickness following an insect bite, and contact a doctor if you suspect transmission of an insect-borne disease.

First aid is aimed at reducing the discomfort caused by an insect bite or sting and preventing infection:

• Get away from the insects to avoid additional bites or stings.
• For stings, scrape the stinger away - do not use tweezers or otherwise pinch a stinger, as this will cause more venom to be injected into the wound.
• Place an ice pack over the affected area to reduce pain and swelling.
• Apply hydrocortizone, calamine lotion, or make a paste from three parts baking soda and one part water and apply that to the affected area.
• Give the patient an antihistamine such as Benadryl.
• Remove ticks by pulling them straight out with a pair of tweezers. Be careful not to break a tick's mouth parts off beneath the skin. Contact the child's doctor who may ask you to save the tick and bring it in for testing. Do not try to remove a tick by touching it with a hot match head or by covering it with petroleum jelly.
• Do not scratch
• Wash the affected area with soap and water.

Spider bites

Spiders in the United States are generally harmless, with several exceptions. The most notable are the black widow and brown recluse spiders. Their bites are serious but rarely fatal.

Bites by non-poisonous spiders should be treated the same as insect bites. Bites by poisonous spiders should be treated as follows:

1. Place ice over the bite to reduce pain.
2. Hospitalize victims who are under 16 or over 65 for observation.
3. Be prepared to give antivenin in severe cases.