PT III Insect Bites & Stings (McIntyre) (Exam 3)

b. mosquitoes

bugs preferred habitat:

warm, humid climates

a. chiggers

b. mosquitoes

c. spiders

d. bedbugs

e. fleas

f. ticks

c. spiders

bugs preferred habitat:

no specific preference

a. chiggers

b. mosquitoes

c. spiders

d. bedbugs

e. fleas

f. ticks

d. bedbugs

bugs preferred habitat:

bedding, walls, floors, clothing, etc.

a. chiggers

b. mosquitoes

c. spiders

d. bedbugs

e. fleas

f. ticks

e. fleas

bugs preferred habitat:

warm, humid climates (pet fur, hair, etc.)

a. chiggers

b. mosquitoes

c. spiders

d. bedbugs

e. fleas

f. ticks

f. ticks

bugs preferred habitat:

wooded or grassy areas

a. chiggers

b. mosquitoes

c. spiders

d. bedbugs

e. fleas

f. ticks

a. chiggers

bite presentation:

small red papules of hardened skin

a. chiggers

b. mosquitoes

c. spiders

d. bedbugs

e. fleas

f. ticks

b. mosquitoes

bite presentation:

large welt surrounded by redness

a. chiggers

b. mosquitoes

c. spiders

d. bedbugs

e. fleas

f. ticks

c. spiders

bite presentation:

distinct puncture marks surrounded by redness

a. chiggers

b. mosquitoes

c. spiders

d. bedbugs

e. fleas

f. ticks

d. bedbugs

bite presentation:

larger red marks that appear in a cluster or line

a. chiggers

b. mosquitoes

c. spiders

d. bedbugs

e. fleas

f. ticks

e. fleas

bite presentation:

small, bright red marks that may or may not form a pattern

a. chiggers

b. mosquitoes

c. spiders

d. bedbugs

e. fleas

f. ticks

f. ticks

bite presentation:

bug may still be attached to skin, redness surrounding mark

a. chiggers

b. mosquitoes

c. spiders

d. bedbugs

e. fleas

f. ticks

a. chiggers

typical symptoms:

delayed reaction: itchiness, dry/hardened skin at puncture site

a. chiggers

b. mosquitoes

c. spiders

d. bedbugs

e. fleas

f. ticks

b. mosquitoes

typical symptoms:

extreme itchiness

a. chiggers

b. mosquitoes

c. spiders

d. bedbugs

e. fleas

f. ticks

c. spiders

typical symptoms:

varies widely, can be serious (SOB, fever, etc.)

a. chiggers

b. mosquitoes

c. spiders

d. bedbugs

e. fleas

f. ticks

d. bedbugs

typical symptoms:

delayed formation of mark, intense itchiness

a. chiggers

b. mosquitoes

c. spiders

d. bedbugs

e. fleas

f. ticks

e. fleas

typical symptoms:

very itchy

a. chiggers

b. mosquitoes

c. spiders

d. bedbugs

e. fleas

f. ticks

f. ticks

typical symptoms:

itchy papules, may include other symptoms (bull's eye mark, spotted rash, flu-like symptoms, etc.)

a. chiggers

b. mosquitoes

c. spiders

d. bedbugs

e. fleas

f. ticks

hypersensitivity to bug bites that may cause systemic symptoms or spread of rash

tick bite with systemic symptoms

signs of infection at the bite area

patients <2 years of age

suspected spider bite with symptoms that require medical attention

what are the self-care exclusions for insect bites? (5)

relieve swelling, itching, and pain

prevent secondary infection

prevent future bug bites

what are the goals of treatment for insect bites? (3)

wash bite with soap and water

apply a cold compress to the affected area (10 min on, 10 min off)

avoid scratching - keep fingernails trimmed

avoid rough clothing around the bite

what are the non-pharm recommendations for relief of swelling, itching, and pain? (4)

tick removal

use tweezers to grasp head

pull up DO NOT TWIST

wash hands and bite with soap

never crush a tick with your fingers

tick disposal

place in paper towel soaked with rubbing alcohol, put in bag, flush

what are the non-pharm recommendations for preventing secondary infections? (2)

within 36 hours

how long after a tick bites should it be removed?

avoids swamps or dense wood, especially at dawn/dusk (cover in clothing)

keep pets free of pests

remove standing water around home

use barrier (screens and netting)

what are the non-pharm recommendations of prevention of future bug bites? (4)

looking for signs of infestation (rusty stains on mattresses, bed sheets, furniture)

keep the infestation from spreading (remove infested items)

killing active bed bugs (heat treatment, exterminator)

what are non-pharm recommendations for bed bug infestation? (3)

DEET (N,N-diethyl-m-toluamide)

what is the best all-purpose bug repellant?

20% or higher

what DEET percent is recommended to prevent tick bites?

50% or higher

what DEET percent has shown no additional benefit plus more risk of adverse effects?

30% or less

do not use in children <2 years of age

what concentrations of DEET are preferred in children?

combination of bug repellant and sunscreen (sunscreen every 2 hours, bug spray every 4-6 hours)

what does the FDA recommend against for preventing bug bites?

local anesthetic

topical antihistamines

counter irritants

hydrocortisone

skin protectants

what are the five treatment options for insect bites & stings?

only apply to small area (1-2% BSA)

apply 1-3 times per day up to 7 days

what are the directions for local anesthetics?

camphor and menthol

what counter irritant is recommended?

apply 3-4 times per day up to 7 days

what are the directions for applying camphor and menthol?

hydrocortisone 0.5-1%

decreases redness, inflammation, and irritation at bite area

calamine, zinc oxide, titanium dioxide

what are the skin protectants we need to know? (3)

symptoms of pain, itching and localized swelling last longer than 7 days

localized symptoms worsen during treatment

reaction spreads

when should you refer to provider after follow-up?

allergic reactions

significant allergic response away from site of sting

previous severe reaction to insect stings

personal or family history of significant allergic reactions

children <2 years of age

what are self-care exclusions for insect stings? (5)

relieve swelling, itching and pain

monitor for allergic reactions

prevent future insect stings

what are the goals of treatment for insect stings? (3)

remove stinger

apply a cold compress to affected area

what are non-pharm recommendations for relief of swelling, itching, and pain for insect stings?

avoid wearing perfumes or scented lotions

wear muted colors

control odors in picnic and garbage areas

destroy nests of stinging insects near home

what are non-pharm recommendations for preventing future insect stings? (4)