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
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Nausea
Facial swelling
Difficulty breathing
Abdominal pain
Deterioration of blood pressure and
circulation (shock)
Severe reaction : Pathophysiology
For mild reactions….
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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..
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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
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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…
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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
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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
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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