Bites and stings – first aid

Basic first aid for common bites and stings

Australia has many animal and insect species that bite or sting. Some bites and stings can be treated on the spot using equipment from a first aid kit.

For certain bites and stings, it is important to act quickly. This may involve pressure bandaging the wound and keeping the person immobile until medical help is available.

Try to stay calm and reassure the person. Don’t tourniquet or cut the wound.

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

Common bites and stings include:

• spider bites (such as red back, funnel-web, mouse, white-tailed)
• bee stings
• European wasp stings
• scorpion stings
• ant and centipede bites
• mosquito bites
• tick bites
• snake bites
• stings from sea creatures (such as blue-ringed octopus, cone shells, box jellyfish and stonefish)
• bites from household pests (including fleas, bedbugs and body lice).

Pressure bandaging and immobilisation for certain bites and stings

Pressure bandaging and immobilisation is useful for some bites and stings, but not all. It is recommended for:

• snakes (including sea snakes)
• funnel-web and mouse spiders
• blue ring octopuses
• cone shells.

It is not recommended for other types of bites and stings.

What is pressure bandaging and immobilisation?

Pressure bandaging and immobilisation slows the movement of venom through the lymphatic system. The lymphatic system is a network of tubes that drains fluid (lymph) from the body’s tissues and empties it back into the bloodstream.

Bandaging the wound firmly tends to squash the nearby lymph vessels, which helps to prevent the venom from leaving the puncture site. If you don’t have any bandages on hand, use whatever is available such as:

• clothing
• stockings
• towels.

Immobilising the limb is another way to slow the spread of venom, sometimes delaying it for hours at a time. This is because the lymphatic system relies on muscle movement to squeeze lymph through its vessels.

Pressure bandaging and immobilisation steps

1. Remove jewellery on the limb (if you are able to do so).
2. If the bite or sting is on a limb, apply a broad pressure bandage over the site. Start bandaging from the bottom of the limb to the top. As you keep bandaging over the sting or bite, if you have a pen or marker, mark the site with an 'X' so the mark can be seen on the outermost bandage. The bandage needs to be firm but not too tight. Continue to look at the colour, temperature and feeling in the fingers or toes.
3. Apply a further bandage using a heavy crepe or elasticised roller bandage (10-15 centimetres wide). Start just above the fingers or toes, and move up towards the bitten limb. Bandaging should not cause numbness, tingling or any colour change to the extremities.
4. If you have a pen or marker, mark the site where the bite is on the bandage with an 'X'.
5. Splint the limb. You can use any hard objects (such as wood planks or magazines) gently tied or bandaged to the limb. This is to ensure there is no or minimal movement of the limb. Tie the legs together (like in the picture below) to further limit movement.
6. Try to keep the person calm and seek immediate medical help.
7. Do not make the person walk to the rescue vehicle – bring the vehicle as close to them as you can.

Don’t tourniquet or cut bites or stings

In the past, a tight tourniquet was recommended as the best method to cut off blood flow and prevent the circulation of venom through the body.

This is no longer advised.

Do not cut a bite to release the venom or try to suck the venom out of the wound.

Also, don’t give the affected person alcohol to drink.

Snake bites

Australia has nearly 200 snake species (around 25 are potentially dangerous). Their most active seasons are in the warmer months during spring and summer.

Snakes like wetlands and waterways.

If you see a snake, keep calm and move away from them.

Some venomous snakes in Victoria to watch out for include:

• tiger snake (most common cause of snake envenoming in Victoria)
• copperhead snake
• red-bellied black snake
• Common or Eastern brown snake.

Snake bite symptoms

Signs of a snake bite are not always visible. In some cases, a person may not even feel a snake biting them.

Symptoms may not be obvious for an hour or more after being bitten. It is important to act quickly if you suspect someone has had a snake bite.

Depending on the type of snake, signs and symptoms may include:

• immediate or delayed pain at the bite site
• swelling, bruising or local bleeding
• bite marks (usually on a limb) that may vary from obvious puncture wounds to scratches that may be almost invisible
• swollen and tender glands in the groin or armpit of the bitten limb
• faintness, dizziness
• nausea and vomiting
• headache
• abdominal pain
• oozing of blood from the bite site or gums
• double or blurred vision
• drooping eyelids
• difficulty in speaking or swallowing
• limb weakness or paralysis
• difficulty in breathing
• occasionally, initial collapse or confusion followed by partial or complete recovery.

First aid for snake bites

Not all Australian snakes are venomous, but you should follow basic first aid techniques, just in case.

1. Follow DRSABCD.
2. Call triple zero (000) and ask for an ambulance.
3. Lie the person down, ask them to keep still and reassure them.
4. Remove jewellery on the limb (if you are able to do so).
5. If the bite or sting is on a limb, apply a broad pressure bandage over the site. Mark the site where the bite is on the bandage with an X.
6. Apply a further elasticised roller bandage (10–15 cm wide), starting just above the fingers or toes and moving upwards on the bitten limb as far as can be reached. Apply the bandage as firmly as possible to the limb. You should be unable to easily slide a finger between the bandage and the skin.
7. Immobilise the bandaged limb using a splint.
8. Keep the person lying down and completely still (immobilised).
9. Continue to check the colour, temperature and feeling in their fingers or toes.
10. Write down the time of the bite and when the bandage was applied. Try to mark the location of the bite site (if known) on the skin with a pen, or photograph the site. Do not wash venom off the skin or clothes because it may assist identification.
11. Stay with the person until medical aid arrives.
12. Do not make the person walk to the rescue vehicle – bring the vehicle as close to them as you can.

Spider bites

First aid for spider bites depends on the species of spider and whether the spider is venomous or not.

Common Australian venomous spiders that may cause harmful bites include:

• funnel-web (species causing significant injury to people are not found in Victoria)
• mouse
• redback.

Spider bite symptoms

General symptoms of spider bites may include:

• sharp pain at bite site
• sweating
• nausea, vomiting and abdominal pain
• burning sensation
• swelling
• blistering.

Funnel-web or mouse spider bite additional symptoms:

• lots of saliva and tears
• muscle twitching
• difficulty breathing
• small hairs stand on end
• numb mouth
• fast pulse and high blood pressure
• disorientation and confusion leading to unconsciousness.

Redback spider bite additional symptoms:

• escalating pain
• patchy sweating
• small hairs stand on end
• headache
• muscle weakness or spasms.

Redback spider bites usually do not cause life-threatening reactions.

First aid for funnel-web and mouse spider bites

1. Follow DRSABCD.
2. Call triple zero (000) and ask for an ambulance.
3. Lie the person down, ask them to keep still and reassure them.
4. Remove jewellery on the limb (if you can).
5. If the bite or sting is on a limb, apply a broad pressure bandage (10–15 cm wide) over the site. If you have a pen, mark the site where the bite is on the bandage with an X.
6. Apply a further elasticised roller bandage (10–15 cm wide), starting just above the fingers or toes and moving upwards on the bitten limb as far as can be reached. As you go back over the bite site, mark it with an X again so the mark can be seen on the outermost bandage. The bandage needs to be firm but not too tight. Continue to check the colour, temperature and feeling in the fingers or toes.
7. Keep the patient lying down and completely still (immobilised).
8. Write down the time of the bite and when the bandage was applied. Try to mark the location of the bite site (if known) on the skin with a pen, or photograph the site. Do not wash venom off the skin or clothes because it may assist identification.
9. Stay with the person until medical aid arrives.
10. Do not make the person walk to the rescue vehicle – bring the vehicle as close to them as you can.

First aid for redback spider and other spider bites

1. Wash the affected area well (with soap and water).
2. Soothe the pain with cold packs or iced water for 15 minutes and reapply if pain continues. Use simple pain relief (such as paracetamol).
3. Seek medical help if symptoms worsen.

Do not bandage the area because pressure will increase pain.

Scorpion stings

Australia has different species of scorpions, fortunately they do not give a lethal sting as they do in some parts of the world.

Some Australian species can give a painful sting that may cause pain and swelling that could last for a few hours.

First aid for scorpion stings

1. Apply a cold pack to the bite or sting area for 15 minutes and reapply if pain continues. Use simple pain relief (such as paracetamol).
2. The cold pack should be changed when necessary to maintain the same level of coldness.
3. Seek medical attention if the pain worsens.

Bee stings

Bee stings can cause different reactions, from mild temporary pain and discomfort to significant swelling and a severe allergic reaction.

First aid for bee stings

1. Remove the sting by sliding or scraping your fingernail across it, rather than pulling at it.
2. Wash the area and apply a cold pack to reduce the swelling.
3. If there is significant pain and swelling, over-the-counter pain medication (such as paracetamol) or an antihistamine may give some relief.

If the person has an allergy to bee stings, they can experience anaphylaxis. If this occurs, they will need an injection of adrenaline (EpiPen®).

First aid for serious reactions or multiple bee stings

1. Remove the sting as soon as possible.
2. If someone has been stung in the mouth or stung many times in a single incident (adults more than 10 times or children more than 5 times) they need to be taken to hospital.
3. Call triple zero (000) and ask for an ambulance.
4. Administer adrenaline (if it is used by the person for bee stings).
5. Keep the person lying down and completely still (immobilised) until the ambulance arrives.

Wasp stings

Unlike a bee, which can only sting once, wasps can sting repeatedly. Wasps emit a scent chemical (pheromone) that alerts other wasps to attack.

Wasp sting symptoms

Wasp stings have certain features, including:

• burning pain
• raised lump
• redness
• local inflammation.

Around 1 in 10 people who are stung 2 or more times become allergic, which means they will experience severe reactions to any subsequent stings.

Wasp first aid

1. Clean the affected area with soap and warm water.
2. Use a cold pack to reduce swelling and pain. Use pain-relieving medication and creams. If there is significant pain and swelling, over-the-counter pain medication (such as paracetamol) or an antihistamine may give some relief.
3. Be alert for signs of anaphylaxis, which is a severe and life-threatening type of allergic reaction.
4. Prolonged swelling at the site of the sting may respond to antihistamines – seek medical advice.
5. If someone has been stung in the mouth or stung many times in a single incident (adults more than 10 times or children more than 5 times) they need to be taken to hospital. Call 000 if necessary.
6. Unlike bees, wasps do not leave a stinger that needs to be removed.

Ant stings

Like bee and wasps, ant stings also carry a high risk of severe allergic reaction.

First aid for ant stings

1. Wash the area and apply a cold pack to reduce the swelling.
2. If there is significant pain and swelling, over-the-counter pain medication (such as paracetamol) or an antihistamine may give some relief.
3. If the person has an ant sting allergy, they may experience anaphylaxis. If this occurs, they will need an injection of adrenaline (EpiPen®).

Centipede stings

Centipede stings can be treated with a cold pack to reduce swelling.

Tick bites

Ticks are common in Australia – they are parasites that live on our blood.

Some types of ticks carry disease that can be harmful to people. Although there are numerous species, it is the paralysis tick that tends to cause the most bites. These types of tick bites can cause an allergic reaction and in some, anaphylaxis (a severe allergic reaction).

Tick bite symptoms

Tick bite symptoms include:

• a rash
• headache
• fever
• flu-like symptoms
• sore glands
• walking unsteadily
• bright light intolerance
• weak limbs
• a paralysed face
• paralysis may occur 4-5 days after a tick has attached and may continue 48 hours after removal.

How to remove a tick

Effective removal of the whole tick is important. Make sure you do a thorough body check.

1. Use an ether-containing aerosol (spray) to freeze and kill the tick. Sprays are available from your pharmacy. The tick should be dead in about 10 minutes after applying the aerosol. Remnants of the dead tick can be brushed away.
2. Small larval ticks can be killed by applying a permethrin-containing cream, and then brushed off.

If you are unable to remove the tick in this way see your doctor.

Tick removal techniques no longer recommended

The following tick removal techniques are no longer recommended. These include:

• Attempting to remove a tick with forceps or tweezers. This can sometimes result in the tick’s head or mouthpiece remaining and these can be difficult to remove. The more a tick is handled, the greater the amount of toxin it will release.
• Holding a flame or hot match to the tick. Not only does this increase a risk of burns, but an agitated tick can release more toxin.
• Using methylated spirits, alcohol or anything else to kill the tick before removing, as more toxin may be released.

First aid for tick bites

Most tick bites heal without any problems.

1. After removal of the tick, wash the area and apply antiseptic and a bandaid or dressing.

Seek medical attention for:

• rash or swelling
• the bite does not clear up
• signs of infection or tissue damage
• feeling weak, unsteady on your feet, unusually sleepy
• double vision
• difficulty breathing or swallowing
• night sweats
• fever.

Some people may have an allergic reaction if they are bitten by a tick in the future.

Blue-ringed octopus bites

Blue-ringed octopus can be found in Victorian beaches. They are not aggressive animals, but their bite is venomous. A bite can cause paralysis.

Blue-ringed octopus bite symptoms

Symptoms of blue-ringed octopus bites include:

• feeling numb around the mouth, tongue, face and neck
• tight chest and difficulty breathing.

First aid for blue-ringed octopus stings:

1. Seek immediate medical help – call triple zero (000) for an ambulance.
2. You may need to commence CPR (cardiopulmonary resuscitation). Even if your efforts seem futile, continue CPR until medical help arrives.
3. Apply pressure bandaging and use a splint to immobilise the limb.

Cone shell stings

Present in reef waters, cone shell stings are venomous.

Cone shell sting symptoms

Symptoms of cone shell stings include:

• pain, swelling and numbness at sting site
• prolonged weakness of muscles, including the respiratory muscles (breathing) which can lead to respiratory failure
• disturbed vision, speech and hearing.

First aid for cone shells

1. Seek immediate medical help – call triple zero (000) for an ambulance.
2. Lie the patient down and ask them to keep still.
3. Apply pressure bandages and use a splint to immobilise the limb.
4. You may need to commence CPR (cardiopulmonary resuscitation).

Other sea creatures first aid

Use the hot water first aid method for stings from:

• blue bottles
• non tropical jelly fish
• stinging fish (such as stonefish, lionfish, bullrout)
• stingray
• crown-of-thorns starfish
• sea urchin.

Hot water first aid method

1. Ensure the water is as hot as you can comfortably tolerate before treating the injured person.
2. Place the injured area in hot water for 20 minutes. This will depend on where the injury is on the person – for instance, helping the person to shower, place hand or foot in hot water or pour hot water over the sting. Do not burn the injured person.
3. Remove the injured area briefly from the hot water before reimmersing.
4. If pain persists, continue hot water treatment. Offer simple pain relief (such as paracetamol).
5. Seek urgent medical treatment at a hospital if symptoms are severe.

Box jellyfish sting

1. Seek immediate medical help.
2. Stop the tentacles from stinging by gently removing the remaining tentacles with gloved fingers, forceps, firm object (like a credit card) or flushing with sea water.
3. Immobilise the limb and bandage firmly.
4. You may need to commence CPR (cardiopulmonary resuscitation).

Antivenom is available.

Jellyfish sting

1. Wash the tentacles off with sea water or remove them by hand.
2. Use cold packs or anaesthetic cream to reduce the pain.

Allergies to bites and stings

Some people may have an allergic reaction to a bite or sting.

Allergic reactions to stings and bites range from mild local reactions at the site of the sting or bite to severe allergic reactions that are life-threatening.

In the case of a severe allergic reaction:

1. Lay the person flat – do not allow them to stand or walk.
2. Give adrenaline injector (such as EpiPen® or Anapen®).
3. Call an ambulance – call triple zero (000).

Preventing infection from bites and stings

Some insects and animals can transfer disease with varying levels of contact. Wherever possible, avoid handling animals that may carry disease and protect against insect stings (such as mosquitoes) with insect repellents and appropriate clothing.

If you are bitten or stung by an insect or animal, apply first aid and then seek medical attention if symptoms are severe or an infection develops.

If bitten by an animal (such as a dog or cat) seek medical attention as there is a high risk of infection.

Where to get help

• In an emergency, call triple zero (000) if the following symptoms occur:
  • difficult and noisy breathing or wheezing
  • swollen tongue
  • throat tightness
  • difficulty speaking or a hoarse voice
  • persistent dizziness and/or collapse
  • paleness, floppiness or not responding in babies and young children
  • signs anaphylaxis may occur (usually less than an hour before) – such as swollen face, lips or eyes; hives or welts; abdominal pain and vomiting
• Victorian Poisons Information Centre Tel. 13 11 26 – seven days a week, 24 hours a day
• Emergency department of the nearest hospital
• Nurse-on-Call Tel. 1300 60 60 24 – for expert health information and advice (24 hours, 7 days)
• Your GP (doctor)
• Urgent Care Clinics
• Your pharmacist
• Anaphylaxis Australia Tel. 1300 728 000
• St John Ambulance Australia Tel. 1300 360 455