BITES / VENOMOUS
ALL LEVELS
DESIGNATION OF CONDITION
Signs and symptoms may include any one or all of the following: pain, local swelling, puncture wounds, bleeding at site, tachycardia, tachypnea, vomiting, abdominal pain, numbness at extremities, and headache. Rapid onset of signs and symptoms indicate a major envenomation.
EMPHASIS ON PATIENT CARE
Scene safety, control of bleeding, prevent further contamination. Do not cut and attempt to remove poison. Do not use any type of cryotherapy on bite wound.
1. Assess the scene for safety. Remove patient to a safe area for assessment and treatment.
2. Primary Management - Assess airway, breathing and circulation and manage as indicated.
3. Manage bite wound and extremity:
A. Remove jewelry from affected limb.
B. Stabilize extremity and place at a level of the heart.
C. Immobilize the bitten extremity
D. Irrigate bite with sterile isotonic solution or sterile water.
E. Keep at the level of the heart
4. Initiate transport to an appropriate medical facility.
5. Consider calling poison control
6. Secondary Management - History, physical exam, vital signs
a. Obtain history of bite.
i. Try to safely identify type of animal.
ii. Ascertain time of bite and onset of signs and symptoms.
b. Keep patient calm and still.
7. If anaphylaxis develops, see Anaphylactic Reaction Treatment Guidelines
8. AEMT / PARAMEDIC
1. In route, initiate IV/IO access in an unaffected extremity; if necessary, titrate isotonic solution to end organ perfusion determined by patient condition.
2. Treat pain per Pain Management Protocol
ALL LEVELS
DESIGNATION OF CONDITION
Signs and symptoms may include any one or all of the following: pain, local swelling, puncture wounds, bleeding at site, tachycardia, tachypnea, vomiting, abdominal pain, numbness at extremities, and headache. Rapid onset of signs and symptoms indicate a major envenomation.
EMPHASIS ON PATIENT CARE
Scene safety, control of bleeding, prevent further contamination. Do not cut and attempt to remove poison. Do not use any type of cryotherapy on bite wound.
1. Assess the scene for safety. Remove patient to a safe area for assessment and treatment.
2. Primary Management - Assess airway, breathing and circulation and manage as indicated.
3. Manage bite wound and extremity:
A. Remove jewelry from affected limb.
B. Stabilize extremity and place at a level of the heart.
C. Immobilize the bitten extremity
D. Irrigate bite with sterile isotonic solution or sterile water.
E. Keep at the level of the heart
4. Initiate transport to an appropriate medical facility.
5. Consider calling poison control
6. Secondary Management - History, physical exam, vital signs
a. Obtain history of bite.
i. Try to safely identify type of animal.
ii. Ascertain time of bite and onset of signs and symptoms.
b. Keep patient calm and still.
7. If anaphylaxis develops, see Anaphylactic Reaction Treatment Guidelines
8. AEMT / PARAMEDIC
1. In route, initiate IV/IO access in an unaffected extremity; if necessary, titrate isotonic solution to end organ perfusion determined by patient condition.
2. Treat pain per Pain Management Protocol