What should be done before admin of black widow antivenin?
Drugs for Tx of brown recluse bite?
dapsone and steroids
Drugs for Tx of black widow spider bite?
benzos, opiates, and muscle relaxants to relieve cramping
Tx of wound with spider bites?
immobilization in neutral position at level of injury
cleansing of brown recluse bite with mild soap
Complications of spider bites?
- 1. anaphylaxis
- 2. tissue necrosis and infection - loss of limb
- 3. coagulopathies
- 4. rhabdomyolysis
- 5. renal failure
Hymenopteran stings include what insects?
bees, hornets, wasps, and ants
Toxic reaction s/s with stings?
When do they usually occur?
When do they usually resolve?
with >/= 10 stings
Systemic reaction to stings s/s?
dyspnea, itching, chills, anaphylaxis
S/S of systemic/anaphylactic reaction?
- changes in LOC
What meds can block s/s of anaphylaxis?
Delayed hypersensitivity reaction occurs when?
- </= 1 wk
- joint effusions, serum sickness, pupura, heart failure, renal failure/nephrotic syndrome, jaundice or bruising r/t hemolytic anemia or thrombocytopenia
Management of wound from a sting?
remove stinger by scraping skin - do not squeeze skin
immobilize in neutral position at level of injury
Complications of stings?
- renal failure
Risk involved with human bites?
Wound considerations with human bites?
take pics if associated with a crime
irrigate with lg amnt of NS
usually delay closure to decrease infection
immobiliozation in neutral position at level of injury
Staphylococcus aureus skin infections?
gram positive usually localized and associated with most skin infections in superficial subcutaneous tissues
S/S of staphylococcus aureas skin infection?
redness, rash, NVD, HA, and aches
onset 2 - 33 days
Pasteurella multocida skin infection?
necrotizing infection that is also seen with animal bites
Causes of pasteurella multocida skin infections?
cellulitis, osteomyelitis, sinusitis, and pleuritis
3h - 3 days
Management of pasteurella multocida skin infections?
Afipia felis or Bartonella henselae skin infections?
cat scratch fever - caught by bite, lick, or scratch from a cat
When does afipia felis/bartonella henselae usually occur?
usually after dealing with kittens
2-3 wks after exposure
lymph node swelling, fever, NV, fatigue
Management of afipia felis/bartonella henselae?
abx not usually indicated unless immunocompromised
antipyretics, analgesics, heat to area
Botulism/Clstridium botulinum causes?
can cause life-threatening paralysis r/t neurotoxin produced by this bacteria
Causes: crush injuries or major trauma
s/s: weakness, blurred vision, difficulty speaking or swallowing, dry mucous membranes, dilated pupils, and progressive muscular paralysis
onset: 4-14 days
Mgmt of botulism/
- debridement of wound
- antitoxin therapy
Gas gangrene bacteria?
intestinal or gallbladder Sx or minor trauma to old scars that contain spores
s/s: soft-tissue crepitus, pain, thin/watery brown drainage, increased pulse, NVD, coma
1 day to 6 wks incubation period
Tetanus bacterial cause?
Where does the bacteria live?
soil, human/animal intestines
early s/s: restlessness, HA, muscle spasms, and pain
Late s/s: stiffness, tonic spasms, exaggerated reflexes, general convulsions, and respiratory depression
onset: 2days to several months - usually 6-10 days
malaise, fever, HA, lymphadenitis, photophobia, muscle spasms, coma, osteomyelitis, abscess, and necrotizing fasciitis
onset: 10 days to several months
Management of rabies?
- clean wound with virus-killing soap
- rabies immune globulin
- rabies vaccine during first 28 days after bite
- days 1, 3, 7, 14, and 28
Group A streptococcus infections?
Where do they occur?
found in throat and on skin
causes necrotizing fasciitis and toxic shock syndrome
- s/s: necrotizing fasciitis, fever, severe pain, swelling, heat, redness - rapidly attacks tissue and destroys muscle and flesh
- streptococcal TSS includes fever, dizziness, and confusion
onset 1 to 3 days
Management of necrotizing fasciitis?
ABX: beta-lactam, supportive therapy for shock
Management of TSS r/t strep infection?
- immunoglobulin G
- supportive therapy