American Medical Association Family Medical Guide - American Medical Association [127]
Insect Stings
Insect stings cause more deaths per year than snakebites, but most insect stings cause only mild reactions, such as redness and swelling. Some stings can be life-threatening and cause anaphylactic shock (see page 916) if a person is allergic to the insect’s venom. The most common stinging insects are honeybees, hornets, wasps, yellow jackets, bumblebees, and fire ants. Only honeybees leave a stinger in the skin.
Some symptoms of insect stings are pain, swelling, redness, itching, and burning. Multiple insect stings can cause rapid swelling, headache, muscle cramps, fever, and drowsiness. Severe allergic reactions to insect stings include severe swelling and itching (including in areas of the body away from the sting), hives, coughing or wheezing, difficulty breathing, stomach cramps, nausea and vomiting, weakness, dizziness, bluish skin color, and unconsciousness.
To treat a severe allergic reaction to an insect sting:
1. If the person seems to be having a severe allergic reaction, call or have someone call 911 or your local emergency number, or send someone for help. If the person has an anaphylaxis kit, help him or her administer a shot of epinephrine (adrenaline); if he or she is unable to administer the injection, give it to him or her yourself by following the instructions on the kit.
2. Give the person an oral antihistamine to help stop the allergic reaction and relieve the symptoms.
Poison ivy
Poison ivy has three shiny leaflets on a stem and may grow as a plant, bush, or vine.
Poison oak
Like poison ivy, poison oak has three leaflets on a stem and may grow as a plant, bush, or vine. The three leaflets resemble oak leaves.
Poison sumac
Poison sumac has two rows of leaflets opposite each other and a leaflet at the tip. It grows as a bush or a tree.
3. If the person stops breathing, start mouth-to-mouth resuscitation immediately (see page 156). If the person’s heart stops beating, perform CPR if you have had CPR training.
To treat an insect sting:
1. If the stinger is embedded in the skin, carefully remove the stinger by gently scraping the skin with a dull knife blade, fingernail, or piece of cardboard. Do not squeeze the stinger with tweezers, which can push the venom into the body.
2. Wash the area gently with soap and water, being careful not to break any blisters.
3. Put ice (wrapped in a cloth) or cold compresses on the sting to decrease absorption and spread of the venom.
4. If the area is swollen or itchy, have the person take an oral antihistamine to stop the reaction and relieve the symptoms.
Poisonous Spider Bites and Scorpion Stings
Bites from poisonous spiders and the stings of some scorpions are especially dangerous for young children, older people, and people who are ill. Two kinds of poisonous spiders are found in the United States—the black widow and the brown recluse (also known as the fiddleback spider). Scorpions are found in the southwestern United States.
Black widow spiders are shiny and black and are about an inch long, including their legs. They have a red hourglass marking on the underside of their body. Brown recluse spiders are dark brown and are about ¾ to 1½ inches long, including their legs. They have a violin-shaped marking on the top of their body, toward the head. Scorpions look like 2-inch-long lobsters or crabs and have a set of pincers. Their tail arches over their back and has a stinger at the tip.
Symptoms of a black widow spider bite include slight redness and swelling and sharp pain around the bite, sweating, nausea and vomiting, stomach cramps, a hard abdomen, muscle cramps, weakness, facial swelling, and tightness in the chest and difficulty breathing.
Symptoms of a brown recluse spider bite include a stinging sensation at the time of the bite, redness at the site of the bite (which turns into a blister), pain at the site that becomes more severe with time, fever with chills, nausea and vomiting, joint pain, and a rash. The person may have blood in his or her urine