Ouch!
What Just Bit Me?
By: Lane Merino, Pharmacy Student/Intern
During the summer months most people will encounter
some kind of biting or stinging insect. About 99.5%
of the population will experience a local reaction,
most commonly a welt, where the remaining 0.5%
will experience some sort of significant hypersensitivity
reaction that will require immediate medical treatment.
The most common types of insect bites and stings
are those of mosquitoes, ticks, chiggers and the
venomous insects; spiders, bees, wasps, hornets
and
yellow jackets. The easiest ways to prevent those
bugs from biting or stinging are to avoid stagnant
water, wear protective clothing, avoid tall grass
if possible and use some sort of insect repellant.
Granted there are many types of bug repellants
on the market, some being: DEET 7-100%, citronella,
eucalyptus oil, and even sulfur powder has been
a
remedy in repelling chiggers; though beware the
warnings and usage directions on the packaging
of these products.
Such warnings that go along with the DEET are children
should only use products containing 30% DEET or
less and children age 2 or younger should not
use DEET
containing products at all due to side effects
such as mental confusion, but there is a safe
alternative
called picaridan that can be safely used.
If
someone is to experience a bug bite or sting, self
care is possible to resolve the situation
being
that most all bites and stings are treated the
same
way. When self treating a bite or sting it is
important to identify what it is that the person
has actually
experienced, i.e. a bee sting or a mosquito bite.
Some insects will leave stingers or will embed
themselves into the flesh of the person.
In the case that a
stinger remains, it will need to be removed.
To remove a stinger you will want a flat sturdy
card such as
a credit card and you will slide that towards
the
stinger from the opposite direction that the
stinger entered the skin; some may not be able
to be retrieved
this way and a drawing salve may be applied such
as a product called PRID®. Other embedding
insects are ticks which they will sink their
head into the
skin and draw blood from the person. To remove
a tick you may place the tick against your thumb
and
butter knife (as close to the base of its insertion
as possible) and turn the tick clockwise and
pull outwards to remove, try to do this without
leaving
the head behind because this can lead to infection.
Smothering it with toothpaste or placing a hot
pin to the tick, will cause it to release and
back out
as well. In both of these situations it is better
advised not to use tweezers to squeeze and pull
stingers or ticks out because more venom could
be released
into the flesh or a pathogen in the tick such
as Lyme Disease may be accidentally squeezed
out into
the blood stream. With all other bites and stings
First it is important to clean the area with
soap and water to free the area of any pathogens
and
then an ice pack needs to be placed to the area
to constrict
blood vessels to stop the spread of any venom
or microorganism and also to decrease swelling.
If
the area effected is bothersome and is itching
that last
thing to do is scratch that area, this can allow
infections to occur in broken skin caused by
intense scratching. A topical formulated local
anesthetic
such as benzocaine 20% or pramoxine 1% may be
used to stop nerve impulses causing the itchy
sensation,
there are also other topical products that can
be used to counter the irritation like hydrocortisone
1% creams, camphor and menthol formulations or
topical/systemic
(orally taken) antihistamines such as Benadryl®.
There are also skin protectants that can be used
if the affected area is weeping, these are topical
zinc oxide cream and calamine lotion. These therapies
should be able to resolve the situation within
a 7 day period; otherwise medical attention is
advised
to take care of the bite or sting.
There
are complications that can occur with insect bites
and stings that are severe and will require
the medical attention of a physician. The signs
and symptoms of possible complications are
flu-like
symptoms
(fatigue, fever, muscle weakness), intense
itching, a bull’s eye rash (Lyme Disease,
caused by Dear Ticks) and hypersensitivity reactions
(rapid
drop in blood pressure, dyspnea [shortness
of
breath], wheezing, nausea, vomiting and diarrhea).
In the
case that someone experiences a hypersensitivity
reaction, commonly referred to as anaphylactic
shock, the use of epinephrine is necessary.
The common method
of epinephrine administration is through the
use of a device called an Epi-Pen®, these
are normally carried by people who have a history
of and are aware
of possible anaphylaxis. To administer one
of these pens to a person the cap needs to
be removed
and
the pen grasped the palm of the administer
needle end towards pinkie finger and then stabbed
into
the outer thigh of the person needing the dose
of epinephrine,
this is to be done directly through the clothing
of the individual; be mindful of the expiration
date on these pens. In any situation like this
if it is
not under control 911 emergency needs to be
contacted and informed of the situation.
Insect
bites and stings are all too common
in the summer months and are minor nuisance
if dealt
with
properly. Self treating bites and stings
can be done safe and effectively now knowing what
you can do
in response to these common and in the not-so-common
situations, but being well prepared and taking
the steps to properly protect yourself is
the
best method
to limit exposure to these pesky insects.
*The
views and opinions of this article is not necessarily
the same views and opinion of AuBurn Pharmacy.
