2017 HCHB_digital

CONTINUING OTC EDUCATION
Tips to avoid getting bitten
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Use insect repellents and cover arms and legs if in an area prone to insects.
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Avoid perfume or wearing bright-coloured clothing around bees; mosquitoes like dark clothing.
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Cover food and rubbish and try to minimise odours at picnics. Destroy hives or nests.
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Drain pools of stagnating water or add household bleach to them to eliminate mosquito larvae.
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Repel mosquitoes with electrical insect-repelling devices or citronella products when outside.
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De-flea cats, dogs and other household pets regularly.
Initial assessment
Ask your customer to show you the sting or bite mark if they are comfortable
doing so in a private area. If they are unsure of the cause, the appearance,
location and quantity of marks should give you some idea (for example, single
bite: wasp or spider; multiple bites: mosquito or flea; itchy rash under swimsuit:
hydromedusae).
Wasp, bee, or hornet stings
Most people will have successfully removed the stinger by the time they present
to a pharmacy for treatment for a wasp or bee sting. If not, carefully scrape away
the stinger with the side of your fingernail rather than grasping it, as this can
accidentally squeeze more venom into the patient.
Ice should be applied to the affected area and an antihistamine tablet offers
the most effective treatment against inflammation and itch. For very minor stings,
a topical corticosteroid cream may be used. Seek urgent medical help for anybody
with a severe allergic reaction or with signs of anaphylaxis (see also Allergies).
Advise customers with severe allergies to insect stings to carry adrenaline at all
times and wear medical alert jewellery.
Insect bites
Suggest topical and oral antihistamines, anti-pruritic (anti-itch) products, topical
corticosteroids, or topical local anaesthetic agents for itching. If the cause is
thought to be due to scabies or head lice, treatment products should be used.
Refer the customer to a pharmacist if they have recently been overseas and
there is a possibility that they may have been bitten by a disease-carrying insect.
Suggest ways to protect against future bites (see text box above).
Spider bites
New Zealand has many species of spider but only the red-back and katipo
are considered poisonous; an anti-venom effective for both these spiders is
available throughout NZ. No deaths from katipo spiders have been reported
here since the 19th century. Although white-tailed spiders are known to
bite, their venom from rarely causes harm, although some people develop
an allergic reaction. Seek urgent medical help if the person has difficulty
breathing or a severe reaction; otherwise ring the NZ Poisons Centre, 0800
POISON (764 766) for more advice.
SOOV CREAM
Soothing antiseptic cream
Ideal for cuts and grazes, minor burns, scalds and
sunburn. Relieves pain and contains antiseptics to help
prevent infection.
• 1% w/w lignocaine hydrochoride to provide fast, soothing pain relief
• 1% w/w cetrimide antiseptic
• Suitable for children and adults.
Refer to
PHARMACIST
Seek urgent medical advice if the person with the bite or sting
has had severe reactions in the past, or has any of the following
symptoms:
• feeling unwell, dizzy or vomiting
• significant swelling, especially around eyes, lips, tongue or neck
• fever, wheezing, tight chest, difficulty breathing or swallowing.
Refer any customers with other health conditions such as
immunosuppression, diabetes, or who are pregnant or breastfeeding
and wanting advice about bite treatment or prevention to the
pharmacist. Also refer customers seeking treatment for young
children or with:
• extensive swelling or redness around the site of the bite or sting
• a previous bad reaction to a bite or sting
• signs of infection (eg, pain, pus, crusting)
• bites caused by an overseas or unknown source
• allergies to certain medicines.
Jellyfish
Bluebottles
Wash stung area in fresh or salt water and remove any stings or tentacles
attached to the skin (but not with bare hands). Immerse affected area in warm
water for 20 minutes then leave to dry without towelling. DO NOT apply vinegar
(increases toxin release).
Lion’s mane jellyfish/mauve stingers
Apply wet sand or a towel soaked in sea water initially, then flush the area with
warm sea water. Vinegar is effective for these types of jellyfish (but fresh water is
not). Wipe remaining tentacles off with a dry towel after five minutes. Cold packs
may help relieve pain.
Hydromedusae
Remove togs as soon as possible after leaving the water. Shower in preferably
salt water. Wear tight-fitting clothes when swimming.
Treatment after first-aid
Lignocaine, calamine lotion, or a mild hydrocortisone cream may be applied to
the skin and oral antihistamines taken if the skin is itchy. Oral corticosteroid
tablets may be prescribed for extensive jellyfish stings.
Medicines have benefits and some may have risks. Always read the label and use only
as directed. If symptoms persist or you have side effects see your healthcare professional.
TAPS PP 7868
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