Duration Health

Envenomation

Introduction

Encounters with insects, snakes, scorpions, and other venomous creatures can occur while traveling within the US and abroad. Most snake bites within the US are caused by coral snakes or pit vipers, such as rattlesnakes and copperheads. Black widow, brown recluse, and hobo spiders are the most prevalent venomous spiders in the USA, but bites and envenomations are rare. Snake and spider bites within the US are rarely fatal, resulting in less than 5-10 deaths per year, but do require immediate medical attention.

Antivenin is the primary treatment for a bite by a venomous animal, however antivenin is not something that can be carried with you or administered in the field. There are many different types of antivenin and the right type needs to be selected depending on the type of bite. Antivenin has to be refrigerated and handled carefully, and can cause serious and even life-threatening reactions so can only be given in a hospital setting. Treatment of some bites may take dozens of doses of antivenin.

Within the USA, bees cause the most deaths of any venomous animal or insect, about 60-70 per year, due to allergic reactions. Bee allergies are not the most common cause of anaphylactic reactions, severe allergic reactions are much more commonly caused by food or medications and it is rare to develop a severe bee allergy as an adult.

These symptoms are a medical emergency. Epinephrine injection should be given immediately and seek emergent medical care.

Treatment

Evacuate and seek emergency medical care right away for any potentially venomous bite.

Do your best to immobilize the body part that has been bitten, and avoid vigorous activity which may increase blood flow to the area of the bite. If you are bitten on the foot or leg, it is best not to walk if at all possible. Try to keep the bitten body part at a neutral level, in line with the heart, when possible.

Snake bite kits, venom extractors, cutting the skin near the bite, or trying to suck out the venom are not useful, and all these treatments can cause infection or increased damage. Tourniquets and pressure dressings are not recommended for any venomous bites within the US.

Pain medications like ibuprofen and acetaminophen can be used for pain, and diphenhydramine may be useful for itching, swelling, or signs of an allergic reaction.

When To Worry

You should seek emergent medical attention for any snake, scorpion, or venomous insect bite.

Also seek emergent medical attention if you are stung or bitten by an insect and experience:

Quick Guide

If you are stung or bitten by an insect and experience

  • wheezing
  • hives
  • swelling of the face or mouth
  • difficulty breathing

You may have

anaphylaxis or a severe allergic reaction

Give

EPINEPHrine injection according to package instructions

AND

diphenhydrAMINE (generic for Benadryl®) 50 mg (adjust for children according to package instructions)

AND

predniSONE 40 mg OR prednisoLONE pediatric dosed appropriately for age

AND

Seek emergency medical care immediately

If you are bitten by any potentially venomous animal

Seek emergency medical care immediately

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Duration Health, Inc.
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2443 Fillmore St #380-7336
San Francisco, CA 94115
(855) 340-8969

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