Remember always seek immediate medical help and call triple zero (000) for an ambulance in an emergency. If the person collapses or stops breathing, you will need to commence CPR (cardiopulmonary resuscitation) until medical help arrives.

Dog/Cat bite 
Dog and cat bites can become infected. Wash wounds with soap and water, apply antiseptic and seek medical aid. Antibiotics may be prescribed and tetanus vaccination should be up checked.

Bee sting
Remove the sting by sliding or scraping your fingernail or plastic credit card across it, rather than pulling at it. Wash the area and apply ice to reduce the swelling. If the person has a serious allergy to bee stings then call 000 and you may need to help give their EpiPen.

Snake bite 

• Call 000
• Keep the bitten limb and the patient STILL.
• Place a folded pad over the bite and apply a broad pressure bandage firmly to the limb, including over the pad on the bite site. Apply the pressure immobilisation bandage to the entire limb as far up as possible, starting just above the fingers for an arm or just above the toes for a leg.
• Immobilise the limb with a splint (stick/rolled up newspaper). Then apply another firm bandage as before over the splint and clothes.
• If the bite is on the trunk or torso, still apply a pressure bandage.
• If the bite is on the head or neck apply firm direct pressure on the bite site if possible. Do not restrict breathing, blood flow or chest movement and keep the patient STILL.

Funnel-web bite 
Keep the patient calm and follow instructions above as for snake bite applying a pressure immobilisation bandage. If safe to do so, collect the spider for identification.

Redback spider bite

• Apply an ice pack to lessen the pain (the pressure-immobilisation technique is not used in this case as the venom acts slowly and any attempts to stop its movement tends to increase local pain, which may become excruciating).
• Get the victim to a hospital or medical centre if a child is affected or symptoms are severe.
• Antivenom is not routinely used.

Bluebottle sting

• Remove any tentacles with tweezers, forceps or fingers (this is not dangerous to the rescuer; you may experience a harmless prickling feeling).
• Wash off with sea water
• Immerse the affected area in hot water (no hotter than the rescuer can comfortably tolerate) for 20 minutes to relieve pain.
• If pain is not relieved by heat, or hot water is not available, stings may respond to ice packs or anaesthetic creams or lotions.
• For persistent or generalised pain, or if the sting area is large or involves sensitive areas, call 000 and seek assistance from a lifeguard.

Stonefish sting

• Call 000
• Immerse the affected area in hot water as tolerated to relieve pain.
• Leave any barbs or spines in place and place padding around them. They may be plugging a wound and preventing blood loss.
• If the person is unresponsive and not breathing properly, start CPR (cardiopulmonary resuscitation).

Box jellyfish sting (tropical waters)

• Dial 000  and seek help from a lifeguard.
• Flood the area with vinegar for at least 30 seconds.
• If vinegar is not available, wash the area well using sea water (not fresh water) and pick off tentacles (this is not harmful to the rescuer).
• Make sure patient does NOT move.
• A cold pack or ice may help relieve pain. Take care not to get fresh water on the area as it could activate further stinging cells.
• CPR may be required.
• Antivenom is available, and is recommended for all but minor stings.

Irukandji (jellyfish) sting
Irukandji syndrome can develop about 30 minutes after being stung. It can be fatal.

• Call for medical assistance, either via a lifeguard or dial 000 for an ambulance.
• Liberally douse the stung area with vinegar.
• The person must be taken to hospital for pain relief and treatment of symptoms.

Blue ring octopus

• Dial 000 – medical help is needed as fast as possible.
• Pressure immobilisation bandages should be applied, using a broad pressure bandage and splint on the affected limb.
• Stay with the person, reassure them and keep them still.
• CPR may be needed.
• Person will need transfer to hospital – prolonged artificial respiration is often required until the effects of the venom wear off.
• There is no antivenom available.

Cone shell sting

• Call 000.
• Pressure immobilisation, using a broad pressure bandage and splint, is recommended.
• Stay with the person, reassure them and keep them still.
• Prolonged artificial respiration, even mechanical ventilation, may be required.
• At this stage, there is no antivenom available for cone shell stings.
• A tetanus injection may also be needed in case the wound is contaminated.

Tick bites 
The Australian paralysis tick secretes a nerve toxin in its saliva.

Kill adult ticks where they are on your skin using a spray that contains ether (available from pharmacies in Australia e.g. Wart Off). These sprays freeze the tick, killing it and preventing it from injecting its saliva or regurgitating its contents into you.

• You should then leave the tick in place until it drops off, which should happen in the next 24 hours. Don’t compress it or squeeze the tick during this time.
• Once the tick has dropped off, clean the area with an antiseptic or soap and water.
• Don’t remove ticks with household tweezers. If you have trouble killing the tick or it doesn’t drop off, visit your doctor for tick removal.
• Seek medical attention if you develop symptoms such as rash, swelling or fever.

In short: Freeze it; Don’t squeeze it! To kill small tick larvae or nymphs, apply insecticide cream containing permethrin, which is available from chemists.

Ant bites

• Wash the stung area with soap and water
• Apply a cold pack to the area and take a simple analgesic if required to relieve pain and swelling
• If the person has a serious allergy to ant stings then call 000 and you may need to help give their EpiPen.

Leech bites

• Application of salt, salt water or vinegar to an actively sucking leech will cause it to fall off. A leech will usually fall off after 20 minutes of attachment without any treatment.
• Wash area with soap and water and use an antiseptic.

Hairy caterpillars

• Remove hairs with tweezers or by applying and removing adhesive tape to the area
• Apply a cold pack to the area and take paracetamol if required for relief of burning, pain and itching.
• Antihistamine medication e.g. Zyrtec tablet

Margaret Bates
School Nurse                                                                                                                                                                                                                  

References 
Victorian Poisons Information Centre, myDr.com.au and healthdirect.com.au