Plant and Animal Emergencies - Huff Hills Ski Patrol and Animal Emergencies ... Anatomy and Physiology ... Dengue Fever Yellow Fever Encephalitis West Nile Virus

National Ski Patrol, Outdoor Emergency Care, 5/e

©2012 by Pearson Education, Inc., Upper Saddle River, NJ

BRADY

Plant and Animal

Emergencies

Chapter 27



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Objectives

27.1 Compare and contrast poison, toxin,

and venom.

27.2 List and describe common toxic plants

encountered in wilderness settings.

27.3 Describe how plants can be harmful to

humans.

27.4 List and describe various land and

marine creatures that may be harmful to

humans. continued



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Objectives

27.5 Describe and demonstrate how to

assess a patient that has been injured

following an encounter with a toxic plant,

an animal, or some marine life.

27.6 Describe and demonstrate how to

manage an exposure to topical toxins.

27.7 Describe and demonstrate the proper

management of wounds caused by

animals, including reptiles, insects, and

spiders.



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Topics

Anatomy and Physiology

Adverse Effects and Emergencies

from Common Plants

Spider, Insect, and Animal Injuries

Assessment

Management

Chapter Summary



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Case Presentation

You step out of the wilderness aid station and notice

a 22-year-old male, with a small limp, complaining of

pain in his leg as ambulatory personnel help him

down the trail entrance. He says he felt a sharp pain,

and noticed a dark brown snake slithering away. He

has two puncture holes in his calf above his boot.



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continued


Epidermis

◦ Waterproof protective barrier to invading

organisms

Dermis

◦ Contains the hair follicles, blood

capillaries, sweat glands and nerve

endings

Hypodermis

◦ Contains many small blood vessels



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continued




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Organs with a high vascular supply

(i.e., major internal organs) absorb

toxins rapidly.

Organs with a low vascular supply

(i.e., the extremities) increase the

potential for infection.

continued



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Note distinction between toxin and

poison:

◦ Toxin: from a living creature

◦ Poison: from either a living creature or

non-living substance

Venom is a toxin or poison specific to

a certain animal (snake, spider,

scorpion, etc.)



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Plants Toxic to the Skin

Poison Ivy

◦ Description

◦ Habitat

◦ Toxic part

◦ Toxic effects

continued



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Poison sumac

◦ Description

◦ Habitat

◦ Toxic part

◦ Toxic effects

continued



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Poison oak

◦ Description

◦ Habitat

◦ Toxic part

◦ Toxic effects



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Stinging nettle

◦ Description

◦ Habitat

◦ Toxic part

◦ Toxic effects

Copyright Dorling Kindersley Media Library



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Plants Toxic to Ingestion

Monkshood

◦ Description

◦ Habitat

◦ Toxic part

◦ Toxic effects

continued

Copyright Clive Bournsel /

Dorling Kindersley Media Library



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Autumn Crocus

◦ Description

◦ Habitat

◦ Toxic part

◦ Toxic effects

continued

Copyright Roger Smith /




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Lily of the Valley

◦ Description

◦ Habitat

◦ Toxic part

◦ Toxic effects

continued

Copyright Demi Brown /




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Foxglove

◦ Description

◦ Habitat

◦ Toxic part

◦ Toxic effects

continued




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Castor Oil Plant

◦ Description

◦ Habitat

◦ Toxic part

◦ Toxic effects

continued

Copyright Steve Gorton /




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Yew

◦ Description

◦ Habitat

◦ Toxic part

◦ Toxic effects

continued

Copyright Roger Smith /




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Pokeweed

◦ Description

◦ Habitat

◦ Toxic part

◦ Toxic effects

continued

Copyright Andrea Lawson /




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Rhododendron

◦ Description

◦ Habitat

◦ Toxic part

◦ Toxic effects

continued

Copyright John Glove /




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Jimson Weed

◦ Description

◦ Habitat

◦ Toxic part

◦ Toxic effects

continued





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Water Hemlock

Belladonna

◦ Description

◦ Habitat

◦ Toxic part

◦ Toxic effects



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Poisonous Mushrooms

Amanita

◦ Description

◦ Habitat

◦ Toxic part

◦ Toxic effects

Copyright Neil Fletcher /


continued



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Poisonous Mushrooms

False morels

◦ Description

◦ Habitat

◦ Toxic part

◦ Toxic effects

Copyright Leighton Moses /


continued



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Poisonous Mushrooms

Little brown

mushrooms

◦ Description

◦ Habitat

◦ Toxic part

◦ Toxic effects



continued



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Poisonous Mushrooms

Jack-o-Lantern

Green-Spored

Lepiota

◦ Description

◦ Habitat

◦ Toxic part

◦ Toxic effects





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Spiders

Black Widow

◦ Description

◦ Habitat

◦ Characteristic of

Bite

◦ Toxic effect

continued



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Spiders

Brown Recluse

◦ Description

◦ Habitat


Bite

◦ Toxic effect

continued



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Spiders

Hobo

◦ Description

◦ Habitat

◦ Characteristic of Bite

◦ Toxic effect

continued



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Spiders

Wolf

◦ Description

◦ Habitat


Bite

◦ Toxic effect

Copyright Frank Greenaway /


continued



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Spiders

Wolf

◦ Description

◦ Habitat


Bite

◦ Toxic effect

Copyright Jerry Young /




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Scorpions

Bark scorpion

◦ Description

◦ Habitat


Bite

◦ Toxic effect




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Ticks

Deer tick

◦ Description

◦ Habitat


Bite

◦ Disease

transmitted

Copyright Pfizer Central Research

continued



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Ticks

Deer tick

◦ Description

◦ Habitat


Bite

◦ Disease

transmitted

Copyright Charles Stewart & Associates

continued



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Ticks

Dog tick

◦ Description

◦ Habitat


Bite

◦ Disease

transmitted




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Bees, Wasps, Hornets

Usually causes pain, swelling, and

joint aching



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Mosquitoes, Fleas, Biting

Flies

Localized

redness, itching,

swelling

Can transmit

illnesses:

◦ Malaria

◦ Dengue Fever

◦ Yellow Fever

◦ Encephalitis

◦ West Nile Virus





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Ants

Localized

redness, itching,

swelling



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Reptiles

Cold-blooded

animals that

regulate their

body temperature

by moving into or

out of the sun.

Characterized by

scales covering

their skin.Copyright Stephen Kirk /




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Rattlesnake

Description

Habitat

Characteristic of

Bite

Toxic effects

continued



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Rattlesnake



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Coral Snake

Description

Habitat

Characteristic of

Bite

Toxic effects

continued



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Alligator and Crocodile

Description

Habitat

Characteristic of

Bite

Toxic effects

Copyright Andy Holligan /




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Marine Creatures

Shark

◦ Description

◦ Habitat

◦ Method of

causing injury

◦ Injuries



continued



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Marine Creatures

Moray eel

◦ Description

◦ Habitat

◦ Method of

causing injury

◦ Injuries

continued



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Marine Creatures

Stingray

◦ Description

◦ Habitat

◦ Method of

causing injury

◦ Injuries

continued



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Marine Creatures

Jellyfish

◦ Description

◦ Habitat

◦ Method of

causing injury

◦ Injuries

continued



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Marine Creatures

Biting fish

◦ Description

◦ Habitat

◦ Method of

causing injury

◦ Injuries

continued

Copyright Colin Keates, Dorling Kindersley

Courtesy of the Natural History Museum, London



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Marine Creatures

Spined fish

◦ Description

◦ Habitat

◦ Method of

causing injury

◦ Injuries





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Mammals

Horse bite

◦ Soft tissue

damage

◦ Broken bones

◦ Localized soft-

tissue infections

continued



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Mammals

Dog bite

◦ Soft tissue

damage

◦ Broken bones

◦ Localized soft-

tissue infections



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Domestic and Wild Dogs,

Wolves, Coyotes, and Foxes

Beware of Dogs Ready to Bite


continued



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Domestic and Wild Dogs,

Wolves, Coyotes, and Foxes

Wolf

◦ Method of causing injury

◦ Injuries



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Domestic and Wild Cats

Method of

causing injury

Habitat

Injuries

Copyright Jerry Young /




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Pack Animals

Horses, Mules, Llamas, Alpacas

◦ Method of causing injury

◦ Injuries



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Rodents and Small Animals

Method of

causing injury

Injuries

Copyright Frank Greenaway, Dorling Kindersley

Courtesy of the Natural Museum, London



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Bats

Method of

causing injury

Injuries





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Moose, Elk, Deer, and Bison

Method of

causing injury

Injuries





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Bear

Method of

causing injury

Injuries

Copyright Christopher and Sally Gabe /




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Case Update

A 22-year-old male is in moderate distress and his

leg is red and swollen. His pulse is 120 BPM,

respiration is 18, BP 110/90. There are no other

signs of trauma, no medical problems, he is not

taking any medications, and has no known allergies.



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Assessment

Immediate life

threatening situation?

Need to assess

ABCDs

Bite? Plant? Large

animal trauma?

Allergies: Patient have

an Epipen®?

Bite or fang marks?Copyright Scott Smith



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Assessment:

Plants and Mushrooms

Assess extend of the rash or trauma;

monitor over time

Monitor vital signs frequently and

watch for shock.



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Assessment:

Spiders and Scorpions

Localized soft

tissue injury

Tissue necrosis

Skin color and

temperature

Monitor for

serious infection

or tissue necrosis



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Assessment: Tick Bites

Monitor site for developing rash

Monitor vital signs

Evidence of fever could mean serious

infection



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Assessment: Tick Bites

Remove tick

properly

Copyright Joanna Cameron /




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Assessment: Bee Stings

Localized

inflammation

Generalized

allergic reaction

Monitor vital

signs closely

Airway



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Assessment: Mosquitoes,

Insects, and Ant Bites

Localized inflammation

Mosquitoes can transmit serious

illnesses:

◦ Fever

◦ Cardiovascular instability

◦ Neurological instability



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Assessment: Snake Bites

Snake bites can be fatal

◦ Monitor amount of inflammation

◦ Signs of abnormal bleeding (i.e. gums or

nose)

◦ Monitor vital signs for shock



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Assessment: Other Reptiles

Major tissue damage, fractures,

amputations

◦ ABCDs

◦ Monitor vital signs for shock

◦ Treat massive bleeding



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Assessment: Mammals

ABCDs

Assess soft tissue injuries for

bleeding

Evaluate for internal injuries

◦ Head & Spine

Monitor vital signs for shock

Assess soft tissue injuries for infection



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Management

Assure scene safety regarding

“creatures” or plant life

Observe Standard Precautions

Manage ABCD-related problems

Call ALS, if needed

Assume spine injury if trauma from

large animal

Urgent evacuation and transport to

definitive care



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Management: Plant Toxins

Skin decontamination

◦ Remove obvious resin or plant material

◦ Vigorously wash with hot water and soap

(including under fingernails)

◦ Clean exposed clothing, equipment, and

supplies with hot water and soap

continued



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Copyright Andy Crawford and Steve Gorton /




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Remove spines with tweezers

Inhaled smoke from fire involving

poisonous or toxic plant

◦ Transport immediately to medical care



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Management: Ingested Plant

or Mushroom Toxins

Provide supportive care measures

If able to identify toxic plant

◦ Call 911 (Poison Control)

◦ Follow direction of poison control



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Management: Insects and

Biting Creatures

Remove stinger

if present

continued



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Management: Insects and

Biting Creatures

Clean using soap and water

Apply ice

Immobilize to prevent spread of

venom (spider or scorpion)

Supportive care & Transport

Epinephrine auto-injector



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Management: Snake Bites

Plan for rapid

evacuation

Immobilize

affected

extremity

Place limb at

heart-level

Avoid heavy

physical exertion continued



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Management: Snake Bites

Do not:

◦ “suck the poison out”

◦ Apply tourniquet (unless arterial

bleeding)

◦ Apply ice



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Management: Marine Injuries

Animal bite

◦ control bleeding & transport

◦ Irrigate all wounds with fresh water and

apply dressing

continued



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Management: Marine Injuries

Stinging injuries

◦ Remove spines; decontaminate

◦ Fresh water showers, vinegar, topical

isopropyl alcohol can provide pain relief;

do not rub area with jellyfish

contamination

◦ Check with local authorities for

frequently encountered species and

recommended therapies

Diver's Alert Network



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Management: Animal Bites

Bleeding control & standard wound

care

Wash injury with sterile or clean water

or saline

Immobilize suspected fractures

Physician evaluation



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Management: Large Animal-

Related Trauma

Treat according to signs and

symptoms present

Control external bleeding

Splint possible fractures

Assume spine injury



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Case Disposition

You are concerned that your patient was bitten by a

rattlesnake. Splint his leg while keeping him supine,

warm, and calm. His friends help you carry him to the

trailhead so that he can avoid exertion. You arrange

transport to the closest hospital so that he can be

treated with antivenom.



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Chapter Summary

Most skin rashes from contact with toxic

plants are not life threatening.

Skin rashes can become infected and

should be evaluated by

a physician.

Minor bites from wild animals are not

usually life threatening.

continued



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Chapter Summary

Bites and scratches by certain small wild

animals warrant evaluation for rabies.

Unexplained altered mental status or

severe nausea/vomiting may be associated

with ingestion of a plant or mushroom

toxin.

continued



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Chapter Summary

When ingestion of a poisonous plant is

suspected, obtain a history of what the

individual ate.

Manage large bites and injuries as you

would any traumatic wound.

Many stings, whether by insects or marine

animals, can be managed with localized

treatment.

continued



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Chapter Summary

Observation of signs of systemic

involvement requires transport to a

medical-care facility.

Taking preventative measures to avoid

animal bites is the best course of action.

Plant and Animal Emergencies - Huff Hills Ski Patrol and Animal Emergencies ... Anatomy and Physiology ... Dengue Fever Yellow Fever Encephalitis West Nile Virus

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