Part Two

Dr.S.Nishan Silva

(MBBS)

Insect Sting

Features

• Features result from the injection of venom or other substances into your skin.

• The venom sometimes triggers an allergic reaction.

• Most reactions to insect bites are mild, causing little itching or stinging.

• A delayed reaction may cause fever, hives, painful joints and swollen glands.

• Only a small percentage of people develop severe reactions (anaphylaxis) to insect venom.

Some - NO reactions…

Some – Moderate reactions

Some – SEVERE reactions

Signs and symptoms of a severe reaction

• Nausea

• Facial swelling

• Difficulty breathing

• Abdominal pain

• Deterioration of blood pressure and circulation (shock)

Severe reaction : Pathophysiology

For mild reactions….

• Move to a safe area.

• Remove the stinger.

• Apply a cold pack 

• Apply hydrocortisone cream (If necessary).

• Take an antihistamine 

• Allergic reactions may include mild nausea and intestinal cramps, diarrhea, or swelling.

For severe reactions..

• If possible give adrenaline.• Have the person take an antihistamine pill if he or

she is able to do so without choking. • Have the person lie still on his or her back with feet

higher than the head.• Loosen tight clothing and cover the person with a

blanket. Don't give anything to drink.• Turn the person on his or her side to prevent

choking if there's vomiting or bleeding from the mouth.• Begin CPR if there are no signs of circulation, such as

breathing, coughing or movement.

Snake Bites

Features

Poisonous Snakes in Sri Lanka

• Cobra• Sri Lankan Krait• Indian Krait• Russell’s Viper• Humped nose viper• Green pit viper• Saw scaled viper• Sea snake

Cobra

Sri Lankan Krait

Indian Krait

Russell’s viper

Humped nose viper

Green pit viper

Saw scaled viper

Sea snake

Do’s in Snake Bite…• Safety !• Call for help• Relieve anxiety• Wash with water and soap (gloves)• Remove constricting jewelry or clothes• Take to hospital – May need AVS• If possible; the dead / alive snake or photo

too

Dont’s in Snake Bite…

• Waste time trying to kill the snake

• No cutting or sucking

• Do not apply any oils / home medications on the wound

• Do not elevate the limb / keep below heart level

• Do not tie with anything

• Assume the snake is non-poisonous

Fainting

Why?• Hypoglycaemia – Lack of glucose to the brain

– Diabetes medication– Missed meals

• Lack of oxygen to the brain– Cardiac cause– Respiratory cause– Vascular cause– Poisonings

• Other

So???• History – Missed meals, previous illnesses• Time of the day• Check

– Pulse• Rhythm for regularity• Volume

– Breathing

• Do– Head among knees– Legs elevated if necessary

Recovery Position

Hypoglycaemia

Features• Changes in levels of

consciousness, including dizziness, drowsiness and confusion.

• Irregular breathing.

• Abnormal pulse (rapid or weak).

• Feeling or looking ill.

• Frankly fainting

Do..• If the conscious victim can take food or fluids,

give him or her sugar, preferably in liquid form.• Any sweet drink would do. No need of tea.• Dextrose vials – best.• If recovered – Advice to inform usual follow up

clinic / doctor• If not recovering

– Re check – Pulse, breathing– Hurry to the Hospital

Heart Attacks

Features• Known to have previous heart disease?

• Risk factors of heart disease?

• “Angina Pectoris” – Typical ischaemic chest pain?

• Autonomic features – Nausea, sweating

• Shotness of breath

• Arrythmias – Palpitations

• Unconsciousness

• May be even “Arrest”

First Aid Video

Do’s• Assess vital signs

• CPR if arrested

• Good ventilation

• Prop up if necessary

• GTN (nitrate) sub-lingual – can repeat

• Aspirin – 300mg at once

• Pain killer

• Take to hospital ASAP