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

Nausea
Facial swelling
Difficulty breathing
Abdominal pain
Deterioration of blood pressure and
circulation (shock)

Severe reaction : Pathophysiology

For mild reactions.

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..

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

Cobra
Sri Lankan Krait
Indian Krait
Russells Viper
Humped nose viper
Green pit viper
Saw scaled viper
Sea snake

Cobra

Sri Lankan Krait

Indian Krait

Russells viper

Humped nose viper

Green pit viper

Saw scaled viper

Sea snake

Dos in Snake Bite

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

Donts 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

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

Dos

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