This document provides information about plant-induced dermatitis, insect bites, snake bites, and allergic reactions. It describes common irritants like poison ivy and stinging nettles. It outlines signs and symptoms of bites/rashes and steps to take, including cleaning wounds, applying anti-itch treatments, and using epinephrine auto-injectors for severe allergic reactions. The document stresses that venomous snake bites require immediate evacuation and medical treatment.

1. Bites, Stings,
Rashes, Allergies
and Anaphylaxis
Covers Chapters 17, 18, 19, & 29

2. Plant-Induced Dermatitis
• About 85% of the population is sensitive to poison
ivy, poison oak, and poison sumac.
• The resin of these plants is a colorless or slightly
yellow, light oil.
• Not visible on human skin
− Spreads by direct contact
− Can stay active for months or years

3. Poison Ivy and Poison Oak
• Low bushes or climbing vines
• Waxy, broad, green leaves in
summer
• Brown to red leaves in fall
• Leaflets grow in groups of three. © Thomas Photography LLC/Alamy.
© Thomas J. Peterson/Alamy.

4. Poison Sumac
• Found in damp, swampy areas
Courtesy of US Fish & Wildlife Service.

5. Plant-Induced Dermatitis:
What to Look For
• Itching
• Mild dermatitis
• Itching and swelling
• Moderate dermatitis
• Itching, swelling, and blisters
• Severe dermatitis

6. Plant-Induced Dermatitis:
What to Do
(1 of 4)
• If within 1 hour of an exposure:
− Gently wipe skin with rubbing alcohol. Do not use
packaged alcohol wipes.
− Wash skin with soap and cold water. Rinse with cold water.
− Do not use gasoline.

7. Plant-Induced Dermatitis:
What to Do
(2 of 4)
• For mild reaction (itching):
− Apply any of the following:
• Colloidal oatmeal bath
• Baking soda paste
• Calamine lotion
• Aluminum acetate solution
• Physician-prescribed medication
• Over-the-counter hydrocortisone

8. Plant-Induced Dermatitis:
What to Do
(3 of 4)
• For moderate reaction
(itching and swelling):
− Same care as mild reaction.
− Apply a physician-
prescribed steroid
ointment.
© pinkannjoh/age fotostock.

9. Plant-Induced Dermatitis:
What to Do
(4 of 4)
• For severe reaction (itching, swelling, and blisters):
− Same care as mild reaction.
− Apply physician-prescribed topical or oral steroid.
− Evacuate if the person inhaled smoke from a burning plant
or if reaction involves face, eyes, genitals, or large area of
the body.

10. Stinging Nettle
• Has stinging hairs on its stem
and leaves.
• Fine needlepoint penetrates
the skin and injects an
irritating chemical.
• Effects result from a direct
irritant effect of the plant’s
sap.

11. Stinging Nettle Poisoning:
What to Look For
• Effects are limited to exposed area.
• Response is usually immediate.
• Produces some degree of:
− redness;
− burning; and
− itching.

12. Stinging Nettle Poisoning:
What to Do
• Wash area with soap and water.
• Apply cold, wet pack.
• Apply calamine lotion.
• Take an over-the-counter antihistamine.

13. Snake Bites
(1 of 6)
• In the United States, 7,000 to 8,000 people are bitten
by venomous snakes annually.
• There are four types of venomous snakes:
• Rattlesnake
• Copperhead
• Water moccasin (cottonmouth)
• Coral snake

14. Snake Bites
(2 of 6)
©DennisW.Donohue/Shutterstock.©RolfNussbaumer/agefotostock.
©Shackleford-Photography/Shutterstock.©AmeeCross/Shutterstock.

15. Snake Bites
(3 of 6)
• Snake bites can be painful, costly, and potentially
deadly.
• Partial or complete loss of an extremity or finger or
loss of movement in a joint can occur.
• Most people recover.

16. Snake Bites
(4 of 6)
• Rattlesnakes, copperheads, and water moccasins are
pit vipers.
• Venomous snakes and nonvenomous snakes have
differing features.
© Jones & Bartlett Learning. © Jones & Bartlett Learning.

17. Snake Bites
(5 of 6)
• Coral snakes
− Small and colorful
− Series of bright red,
yellow, and black bands
around its body
© Rolf Nussbaumer/age fotostock.

18. Snake Bites
(6 of 6)
• At least one type of
venomous snake is
found in every state
except Alaska, Hawaii,
and Maine.

19. Pit Vipers
• Pit vipers are found in every state but Alaska,
Maine, and Hawaii.
• Rattlesnakes are the most widespread.
• Eastern and Western diamondback rattlesnakes
account for almost 95% of snakebite deaths.

20. Pit Viper Bites: What to
Look For
• Severe burning pain
• Two small puncture
wounds
• Swelling
• Discoloration
• Blood-filled blisters
• Nausea, vomiting,
sweating, weakness
© American Academy of Orthopaedic Surgeons.
© American Academy of Orthopaedic Surgeons.

21. Pit Viper Bites: What to Do
(1 of 2)
• Get the person and bystanders away from the snake.
• Do not try to capture or kill the snake.
• Encourage the person to rest, stay calm, and be still.
• Remove any rings, jewelry, or tight clothing from the
bitten body part.

22. Pit Viper Bites: What to Do
(2 of 2)
• Gently wash the bite with soap and running water.
• Apply a sterile dressing over the fang marks.
• Keep the bite area at the level of the heart.
• Evacuate immediately.
• When possible, carry the person
• Do not apply a pressure bandage.

23. Coral Snakes
• Found in Arizona, Texas, and Southeastern United
States.
• America’s most venomous snake, but it rarely bites
people.
• Symptoms begin 1 to 5 hours after the bite.

24. Coral Snake Bites:
What to Look For
• Several hours may pass before the onset of:
− minimal pain;
− drowsiness;
− weakness;
− pricking, tingling of skin;
− blurred vision;
− difficulty swallowing;
− sweating; and
− mouth watering.

25. Coral Snake Bites:
What to Do
• Gently clean the bite with soap and water.
• Apply a wide elastic bandage using overlapping
turns and wrap upward from the end of bitten arm
or leg, covering the entire bite wound.
• Stabilize the bitten arm or leg as you would for a
broken bone. Keep it below heart level.
• Evacuate.

26. Nonvenomous Snakes
• Nonvenomous snakes inflict the most bites.
• Assume a snake is venomous if you don’t know
what type it is.

27. Nonvenomous Snake Bites:
What to Look For
• Horseshoe shape of tooth marks on skin
• Bleeding
• Possible swelling, mild itching, and tenderness

28. Nonvenomous Snake Bites:
What to Do
• Gently clean with soap and water.
• Care for the bite as you would a shallow wound.
• Consult with a physician.

29. Other Reptile Bites
• Venomous lizards include:
− Gila monster
− Mexican beaded lizard
• Venomous lizards may hang
on during a bite and chew
venom into person’s skin.
©MattJeppson/ShutterStock.
©LeonardLeeRueIII/Science
Source/Gettyimages.

30. Other Reptile Bites:
What to Look For
• Puncture wounds
• Swelling and pain
• Sweating
• Vomiting
• Increased heart rate
• Shortness of breath

31. Other Reptile Bites:
What to Do
• Give pain medication.
• Evacuate
• Treat bites the same as you would for a pit viper bite.

32. Treatment and Prevention
of Insect Bites
• Mosquitoes
• Avoid scratching to prevent open wounds
• Itching can be treated with topical agents
• Mosquitoes carry risk of many viruses/diseases
• Prevent mosquito bites at campsites with adequate
netting
• Set camps away from standing water, swamps, dense brush.

33. Treatment and Prevention
of Insect Bites
• Ticks
• Can carry 1 of at least 8 diseases.
• Repelled by many mosquito repellants.
• Perform body checks for ticks twice daily while
hiking/camping.
• Remove ticks immediately.
• Embedded ticks should be pulled slowly with tweezers.

34. General Information
• Immune system produces histamines in response to
foreign allergens.
• Allergic reaction is an overproduction of histamines.
• Allergens can be ingested, inhaled, or absorbed.

35. Hives:
What to Look For
• Pink, blotchy, itchy
bumps on the skin
ranging from less than ½
inch to several inches in
diameter
© Charles Stewart MD, EMDM MPH.

36. Assessment and Treatment of
Allergies and Anaphylaxis
• Allergic reactions can be non-life-threatening or
life-threatening.
• Non-life-threatening reactions can be treated with
antihistamines
• Anaphylaxis is severe and may produce shock
• Includes difficulty breathing, swelling of face, lips,
tongue
• Is lethal
• Reversible only by immediate injection of epinephrine
(adrenaline)

37. Use of an EpiPen Auto-
Injector
•Using the EpiPen:
1. Pull off the blue safety cap.
2. Place the orange tip on the
outer thigh, half-way
between the hip and knee.
3. Push the unit against the
thigh until it clicks, and hold it
in place for 3 seconds.
4. Rub the injection area for 10
seconds.

38. Prevention of Allergies
and Anaphylaxis
• Trip leaders who know of anyone in their party
susceptible to severe reactions should avoid taking
known allergens on the trip.
• Individuals on trips who are susceptible to
anaphylaxis should carry at least three injections of
epinephrine.

39. Evacuation Guidelines
• Mild to moderate reactions can be managed in the
field and do not require evacuation.
• Anyone treated for anaphylaxis should be
evacuated rapidly.
• During evacuation, the patient should be well-
hydrated and kept on a regimen of oral
antihistamines.