Basic Survival Medicine

BITES AND STINGS

4-66. Insects and related pests are hazards in a survival situation. They not only cause irritations, but they are often carriers of diseases that cause severe allergic reactions in some individuals. In many parts of the world you will be exposed to serious, even fatal, diseases not encountered in the United States.

Ticks can carry and transmit diseases, such as Rocky Mountain spotted fever common in many parts of the United States. Ticks also transmit Lyme disease.
Mosquitoes may carry malaria, dengue, and many other diseases.
Flies can spread disease from contact with infectious sources. They are causes of sleeping sickness, typhoid, cholera, and dysentery.
Fleas can transmit plague.
Lice can transmit typhus and relapsing fever.

4-67. The best way to avoid the complications of insect bites and stings is to keep immunizations (including booster shots) up-to-date, avoid insect-infested areas, use netting and insect repellent, and wear all clothing properly.

4-68. If you are bitten or stung, do not scratch the bite or sting; it might become infected. Inspect your body at least once a day to ensure there are no insects attached to you. If you find ticks attached to your body, cover them with a substance (such as petroleum jelly, heavy oil, or tree sap) that will cut off their air supply. Without air, the tick releases its hold, and you can remove it. Take care to remove the whole tick. Use tweezers if you have them. Grasp the tick where the mouthparts are attached to the skin. Do not squeeze the tick's body. Wash your hands after touching the tick. Clean the tick wound daily until healed.

TREATMENT

4-69. It is impossible to list the treatment of all the different types of bites and stings. However, you can generally treat bites and stings as follows:

If antibiotics are available for your use, become familiar with them before deployment and use them.
Predeployment immunizations can prevent most of the common diseases carried by mosquitoes and some carried by flies.
The common fly-borne diseases are usually treatable with penicillins or erythromycin.
Most tick-, flea-, louse-, and mite-borne diseases are treatable with tetracycline.
Most antibiotics come in 250 milligram (mg) or 500 mg tablets. If you cannot remember the exact dose rate to treat a disease, 2 tablets, 4 times a day, for 10 to 14 days will usually kill any bacteria.

BEE AND WASP STINGS

4-70. If stung by a bee, immediately remove the stinger and venom sac, if attached, by scraping with a fingernail or a knife blade. Do not squeeze or grasp the stinger or venom sac, as squeezing will force more venom into the wound. Wash the sting site thoroughly with soap and water to lessen the chance of a secondary infection.

4-71. If you know or suspect that you are allergic to insect stings, always carry an insect sting kit with you.

4-72. Relieve the itching and discomfort caused by insect bites by applying—

Cold compresses.
A cooling paste of mud and ashes.
Sap from dandelions.
Coconut meat.
Crushed cloves of garlic.
Onion.

SPIDER BITES AND SCORPION STINGS

4-73. The black widow spider is identified by a red hourglass on its abdomen. Only the female bites, and it has a neurotoxic venom. The initial pain is not severe, but severe local pain rapidly develops. The pain gradually spreads over the entire body and settles in the abdomen and legs. Abdominal cramps and progressive nausea, vomiting, and a rash may occur. Weakness, tremors, sweating, and salivation may occur. Anaphylactic reactions can occur. Symptoms may worsen for the next three days and then begin to subside for the next week. Treat for shock. Be ready to perform CPR. Clean and dress the bite area to reduce the risk of infection. An antivenin is available.

4-74. The funnelweb spider is a large brown or gray spider found in Australia. The symptoms and the treatment for its bite are as for the black widow spider.

4-75. The brown house spider or brown recluse spider is a small, light brown spider identified by a dark brown violin on its back. There is no pain, or so little pain, that usually a victim is not aware of the bite. Within a few hours a painful red area with a mottled cyanotic center appears. Necrosis does not occur in all bites, but usually in 3 to 4 days, a star-shaped, firm area of deep purple discoloration appears at the bite site. The area turns dark and mummified in a week or two. The margins separate and the scab falls off, leaving an open ulcer. Secondary infection and regional swollen lymph glands usually become visible at this stage. The outstanding characteristic of the brown recluse bite is an ulcer that does not heal but persists for weeks or months. In addition to the ulcer, there is often a systemic reaction that is serious and may lead to death. Reactions (fever, chills, joint pain, vomiting, and a generalized rash) occur chiefly in children or debilitated persons.

4-76. Tarantulas are large, hairy spiders found mainly in the tropics. Most do not inject venom, but some South American species do. They have large fangs. If bitten, pain and bleeding are certain, and infection is likely. Treat a tarantula bite as for any open wound, and try to prevent infection. If symptoms of poisoning appear, treat as for the bite of the black widow spider.

4-77. Scorpions are all poisonous to a greater or lesser degree. There are two different reactions, depending on the species:

Severe local reaction only, with pain and swelling around the area of the sting. Possible prickly sensation around the mouth and a thick-feeling tongue.
Severe systemic reaction, with little or no visible local reaction. Local pain may be present. Systemic reaction includes respiratory difficulties, thick-feeling tongue, body spasms, drooling, gastric distention, double vision, blindness, involuntary rapid movement of the eyeballs, involuntary urination and defecation, and heart failure. Death is rare, occurring mainly in children and adults with high blood pressure or illnesses.

4-78. Treat scorpion stings as you would a black widow bite.

SNAKEBITES

4-79. The chance of a snakebite in a survival situation is rather small, if you are familiar with the various types of snakes and their habitats. However, it could happen and you should know how to treat a snakebite. Deaths from snakebites are rare. More than one-half of the snakebite victims have little or no poisoning, and only about one-quarter develop serious systemic poisoning. However, the chance of a snakebite in a survival situation can affect morale, and failure to take preventive measures or failure to treat a snakebite properly can result in needless tragedy.

4-80. The primary concern in the treatment of snakebite is to limit the amount of eventual tissue destruction around the bite area.

4-81. A bite wound, regardless of the type of animal that inflicted it, can become infected from bacteria in the animal's mouth. With nonpoisonous as well as poisonous snakebites, this local infection is responsible for a large part of the residual damage that results.

4-82. Snake venoms not only contain poisons that attack the victim's central nervous system (neurotoxins) and blood circulation (hemotoxins), but also digestive enzymes (cytotoxins) to aid in digesting their prey. These poisons can cause a very large area of tissue death, leaving a large open wound. This condition could lead to the need for eventual amputation if not treated.

4-83. Shock and panic in a person bitten by a snake can also affect the person's recovery. Excitement, hysteria, and panic can speed up the circulation, causing the body to absorb the toxin quickly. Signs of shock occur within the first 30 minutes after the bite.

4-84. Before you start treating a snakebite, determine whether the snake was poisonous or nonpoisonous. Bites from a nonpoisonous snake will show rows of teeth. Bites from a poisonous snake may have rows of teeth showing, but will have one or more distinctive puncture marks caused by fang penetration. Symptoms of a poisonous bite may be spontaneous bleeding from the nose and anus, blood in the urine, pain at the site of the bite, and swelling at the site of the bite within a few minutes or up to 2 hours later.

4-85. Breathing difficulty, paralysis, weakness, twitching, and numbness are also signs of neurotoxic venoms. These signs usually appear 1.5 to 2 hours after the bite.

4-86. If you determine that a poisonous snake bit an individual, take the following steps:

Reassure the victim and keep him still.
Set up for shock and force fluids or give by intravenous (IV) means.
Remove watches, rings, bracelets, or other constricting items.
Clean the bite area.
Maintain an airway (especially if bitten near the face or neck) and be prepared to administer mouth-to-mouth resuscitation or CPR.
Use a constricting band between the wound and the heart.
Immobilize the site.
Remove the poison as soon as possible by using a mechanical suction device. Do not squeeze the site of the bite.

4-87. You should also remember four very important guidelines during the treatment of snakebites. Do not—

Give the victim alcoholic beverages or tobacco products. Never give atropine! Give morphine or other central nervous system (CNS) depressors.
Make any deep cuts at the bite site. Cutting opens capillaries that in turn open a direct route into the blood stream for venom and infection.

NOTE: If medical treatment is over 1 hour away, make an incision (no longer than 6 millimeters [1/4 inch] and no deeper than 3 millimeters [1/8 inch]) over each puncture, cutting just deep enough to enlarge the fang opening, but only through the first or second layer of skin. Place a suction cup over the bite so that you have a good vacuum seal. Suction the bite site 3 to 4 times. Suction for a MINIMUM of 30 MINUTES. Use mouth suction only as a last resort and only if you do not have open sores in your mouth. Spit the envenomed blood out and rinse your mouth with water. This method will draw out 25 to 30 percent of the venom.

Put your hands on your face or rub your eyes, as venom may be on your hands. Venom may cause blindness.
Break open the large blisters that form around the bite site.

4-88. After caring for the victim as described above, take the following actions to minimize local effects:

If infection appears, keep the wound open and clean.
Use heat after 24 to 48 hours to help prevent the spread of local infection. Heat also helps to draw out an infection.
Keep the wound covered with a dry, sterile dressing.
Have the victim drink large amounts of fluids until the infection is gone.

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