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Environmental

Animal and Insect

Bites and Stings

Signs and Symptoms: Differential Diagnosis:
• Rash, Skin Break, Wound, Retained Stinger • Bite/Envenomation
• Pain, Swelling, Erythema • Other Allergic Reaction
• Bleeding/Discharge • Anaphylaxis
• Shortness of Breath/Wheezing/Throat Tightness • Rabies/Tetanus Risk
• Hypotension or Shock

For SPIDER/SCORPION see: SPIDER For SNAKEBITE see: Snakebite Envenomation
and SCOR RPION Envenomation

Universal Patient Care Guideline
Continued from: O2 (if Hypoxemic)
Tactical Evacuation Guideline IV/IO Guideline
IV/IO in non-effected limb Cardiac
Monitor prn
• Elevate bitten extremities
• Wash wound w/ soap & water
Position patient supine • Mark suspected bite area
• Ice/cold packs for swelling/pain
• Follow local/surgeon policy/CPG
Allergic Reaction Guideline YES • Allergic Reaction?
NO
Pain Management Guideline
When appropriate, return to:
Tactical Evacuation Guideline

Pearls:
ENVIRONMENTAL
• Never attempt to capture/transport a live animal/insect.
• Anaphylactic reactions should be treated as soon as recognized.
• Review country environmental concerns before deployment or visitation.
• All animals should be considered rabid outside the U.S. until proven otherwise. This excludes
rodents, which do not carry rabies.
• Consider IV administration of Calcium Gluconate if tetany develops.
• Elevate effected limb to reduce swelling
• DO NOT apply constricting bandages or tourniquets as these may worsen local tissue injury and
increase the risk of permanent disability.
• DO NOT cut, suck, electrocute, burn, or use chemicals on the envenomation site

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