Oklahoma State Department of Health 01-2018 Revised

BITES-INSECTS (Bees, Wasps, Ants, Spiders, Ticks, Scorpions) Bites/stings can vary in size, shape and discoloration. Most bites/stings do not cause serious injury, although stings from bees, wasps, fire ants and scorpions can cause serious pain. History:  Date/location and insect description surrounding bite/sting  Any known allergies to prior stings  Symptoms of an allergic reaction or anaphylaxis (light headedness, shortness of breath, throat/chest tightening/nausea/vomiting)  Symptoms associated with bites/stings (pain, swelling, itching, burning, redness) Assessment:  Obtain vital signs  Assess for: o Bite mark or blister (redness or swelling) o Difficulty breathing or swallowing, profuse sweating, or salivation o Signs of anaphylaxis (tachycardia, irregular heartbeat or hypotension, swelling to eyes, lips, tongue, or hives on skin) o Nausea or vomiting, fevers and chills, flu-like aches o Severe abdominal pain or eye symptoms (especially in children) could indicate a bite from a black widow spider Treatment:

 Individuals with a history of severe allergic reactions may be carrying an Epipen and may need assistance with its use (see Epipen protocol)  Remove any jewelry or constrictive items in the area of the bite or sting because the affected area may swell  Wash the bite or sting with mild soap and water  Apply cold pack to reduce swelling or baking soda paste to relieve itching. If ice is used, rotate the application of ice as 10 minutes on then 10 minutes off up to 30 minutes  If available, apply OTC 0.5% hydrocortisone cream to skin  Recommend OTC oral antihistamines (e.g., diphenhydramine) to alleviate itching as needed in accordance with manufacturer’s directions for dosage  Wasps, bees and fire ants-quickly but gently remove stinger without squeezing area. Scrape it out with something immediately available such as a stiff piece of paper, credit card, etc.  Ticks-remove tick with tweezers by firmly grabbing the tick’s head as close to the surface of the skin as possible and pulling the tick loose in one piece Refer to Primary Care Provider:

 Any possible infections due to an insect bite/sting  Any known or suspected tick bite  Any suspected scorpion sting (especially in the elderly and children) Call EMS:  History of serious allergic reaction to an insect bite or sting  All cases of suspected allergic or anaphylactic reaction (difficulty breathing; swelling of the lips, eyelids or throat; dizziness, faintness or confusion; tachycardia; hives; nausea, cramps or vomiting)  A scorpion sting to a child Bites Insects- 1

Oklahoma State Department of Health 01-2018 Revised

 All cases of multiple stings by bees, wasps, yellow jackets or fire ants  Any suspected case of a venomous spider bite (black widow, brown recluse). If possible, the insect or spider that bit the person should be sent with them for further medical evaluation and treatment

Reference

Mayo Clinic. Insect bites and stings: first aid. Retrieved electronically October 12, 2017 at http://www.mayoclinic.org/first-aid/first-aid-insect-bites/basics/art-20056593

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