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Wilderness Medicine: What To Do With Bites & Stings

Medically reviewed by Til Jolly, MD, Susan Kerrigan, MD and Marianne Madsen on January 7, 2023

Spending time in nature is one of the best things you can do for yourself. Studies show that spending just a few hours away from crowds and pollution can greatly improve your overall wellbeing. Besides reducing stress, thanks to the sun your body likely enjoys extra Vitamin D. Plus you get clean air for your lungs and exercise from hiking. Unfortunately, too many people put less time into preparation than they would for a trip to the grocery store. That’s a mistake. Because nature isn’t just pretty. It can also kill you. That’s why before you set out for your excursion, you should learn all you can about what to do with bites and stings.

 

A Good Kit

 

Hope for the best. Prepare for the worst. That’s sound advice for innumerable scenarios, but it absolutely applies to any trek into the wilderness. It doesn’t matter if you’re hiking a nature trail, exploring a national park, or camping in the wild, you should start with a solid first aid kit. You can find decent ones at popular outdoor retailers. Your local drugstore may have them as well. Besides the standard anti-bacterial sprays, bandages, and antiseptic wipes, it should be stocked with an over-the-counter antihistamine. These are great when dealing with mild reactions to insect bites. Also a good idea is a supply of anti-inflammatory drugs like ibuprofen, naproxen, or higher dose aspirin. These can help with everything from post-hike aches and pains to treatment for insect bites or stings. You should also make sure to have a supply of topical anti-itch products like Cortizone or Sarna for the same reason. Finally, stock up on mosquito repellent containing DEET or Picaridin.

 

Before you trek in the wild, familiarize yourself with its wildlife. In North America, you could be dealing with rattlesnakes, scorpions, or hornet infestations depending on the region. Across the world, pretty much every locale has its own variety of dangerous insects, snakes, and other creepy crawlers. You should also note if there have been recent problems with cougar or bear attacks and plan your trip accordingly.

 

In the Wilds

 

Pay attention. Unfortunately, many of us have been conditioned to disconnect from our surroundings while focusing on our phone, our music, even our random thoughts. This can have unpleasant consequences in any setting, but the risk rises when you’re in an unfamiliar wilderness. So take in the area not only for its beauty but also for potential threats. It’s far better to avoid a bite or sting in the first place. Keep a safe distance from wild flowers which can attract bees and other stinging insects. Keep an eye out for wasp and hornet’s nests, especially in tree branches overhead. Generally speaking, keep to well-traveled trails. Snakes will do their best to avoid you and will usually only attack if they feel threatened and their retreat is blocked. Be cautious whenever going through brush as snakes may be resting within. If you’re camping, it’s a good idea to shake your boots out before putting them on in the morning as scorpions and spiders often crawl into small, dark places at night.

Although honeybees can only sting once, wasps and hornets can sting repeatedly. Of the three, hornets tend to be most aggressive. Stings from these insects usually cause discomfort at the place where you were stung along with itching, redness, and swelling. This is your body reacting to its venom that has entered your body through its saliva. Check to see if the stinger is still in your skin. Because bees release a sack that will keep pumping venom into your body, you’ll want to remove it.  Although long-standing advice has been to scrape away the stinger with your fingernail, more recently, using tweezers has become accepted. Either way, you’ll want to remove the stinger and disinfect the area with a wipe or antiseptic soap. If ice is available, apply to the area. It’s also a good idea to use an anti-itch cream or other treatment as repeated scratching can lead to infection. 

 

Bees aren’t the only insects that can sting. Fire ants have a very unpleasant sting characterized by clear, small blisters at the bite site. Again, cleansing the area is very important as is watching for serious reactions as people who are allergic to bee stings are also at risk from other insects.  Using their front legs, some centipedes can inject venom, while toxins on a millipede’s body can irritate your skin. If you have itching or redness after handling one of these creatures, make sure to wash well with soap and water. An anti-inflammatory is a good idea as well. 

 

Additionally, an antihistamine is a good idea even for those who aren’t allergic. Watch for signs of a severe reaction –– sometimes the first time someone is aware they are allergic to bee stings is the first time they are stung.  These allergies are frightfully common. Signs of a severe reaction include stomach cramps, hives, and vomiting. If the victim experiences these symptoms or has trouble breathing, they require immediate medical attention. Determine if they carry self-injectable epinephrine. This is usually administered by placing it against the thigh and injecting the medication. 

 

The vast majority of snakes aren’t poisonous, which means that most snake bites aren’t dangerous. However, unless you clearly saw the snake and are comfortable with identifying the species, all snake bites should be treated as potentially lethal. That means seeking immediate medical attention. In the meantime, the bite victim should be kept calm and comfortable because the slightest movement will cause venom to spread. If their clothing is tight around the bite site, it should be removed. If they get cold, give them a blanket. Although some recommend attempting to kill the snake, doing so can lead to more bites. If you can safely take a picture, do so. Giving the victim food, drink or medications may be beneficial in smaller amounts as long as they’re awake and alert.  Do not elevate the bite area or use cold compresses. And despite what you may have learned from watching old movies, you should not attempt to suck the venom out yourself.

Fortunately, in North America there are only two types of poisonous spiders. Unfortunately, a bite from either one of them will seriously interrupt your trip. Identified by its red hourglass on its belly, the 1/2-inch long black widow is perhaps the best known of these (it’s fame is helped along by the Marvel character of the same name). Bites from these spiders can affect your nervous system and, along with severe pain where you are bitten, you may also have chills or fever along with vomiting. The lesser known brown recluse is even more dangerous. Ranging in color from a yellow tan to a dark brown, they are notable for a violin-shaped marking with the base pointing toward its head.  A bite from one of these inch-long spiders can eventually turn the area necrotic –– in other words, it dies. This can spread, resulting in the loss of a limb or even death.

 

In areas with tick infestations, it’s a good idea to wear long pants and long-sleeved shirts. Make it a practice to check for ticks regularly. If you find one on you, grab the base of its body. Then apply steady backward pressure until it lets go. If the head remains, you will want to generously apply an antibiotic cream and put a clean bandage over the area.

 

The risk of being seriously injured by a bite or sting remains small. If you can avoid the more dangerous creatures along with risky, high-altitude selfies, then you should have an enjoyable excursion.  

 

Written by John Bankston

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