Bites and Stings

Key Takeaways – Bites, Stings & The Lymphatic System

• The lymphatic system moves lymph fluid without a pump, using muscle movement—immobilisation is critical after venomous bites to slow venom spread.

• Pressure Immobilisation Technique (PIT) is essential for treating snake bites, funnel-web spider bites, blue-ringed octopus, cone shell stings, and some jellyfish stings.

• Snake bites can cause collapse and cardiac arrest within 10–60 minutes—look for puncture marks, neurological symptoms, and seek urgent medical help.

• Redback spider bites cause intense local pain and swelling—apply a cold compress, avoid PIT, and monitor for worsening symptoms.

• Bee, wasp, and fire ant stings may trigger anaphylaxis—use cold compresses, remove stingers correctly, and follow anaphylaxis first aid if allergic reaction occurs.

• Blue-ringed octopus, cone shell, and box jellyfish stings can be fatal—apply PIT for octopus and cone shell, vinegar for box jellyfish, and call Triple Zero (000).

• Bluebottle jellyfish stings are common—remove tentacles, immerse in hot water for pain relief, avoid vinegar, and seek medical help for severe cases.

• Tick bites may cause allergic reactions—kill ticks in place if allergic, avoid squeezing, and monitor for anaphylaxis.

• Always follow DRS ABCD first aid steps and call 000 in any life-threatening bite or sting emergency.

• CPR First Aid Australia provides accredited training to prepare Australians for effective response to venomous bites and stings.

The Lymphatic System

The Lymphatic System is a network of vessels, nodes, ducts, and organs that produce and transport lymph fluid. The lymphatic system plays a large part in the following:

• Removing fluid from tissues
• Production of immune cells, such as lymphocytes
• Absorbs fat from the intestines

The lymphatic system does not have a pump like the circulatory system; it utilizes muscle movement to transport fluids. The lymphatic system is also predominantly responsible for transporting venom from snake bites. This is why keeping the casualty as still as possible and immobilising the bitten limb is critical. Muscle contractions cause increased lymph movement and, hence, help spread the venom.

Bites and Stings Australia

Bites and stings from particular creatures can be potentially dangerous, and Australia has no shortage of such creatures. This is why looking out for any paired fang marks, scratches, or stings is essential, as well as identifying where or how these came about. Many different varieties of snakes, spiders, and jellyfish carry venom that can cause pain, swelling, and, in extreme cases, death (most commonly through neurotoxic muscle paralysis causing breathing failure).

The most common cause of death from snake bites is collapse with cardiac arrest. This can occur within 10-60 minutes of a bite with envenomation and often before the casualty reaches a hospital.

Other insect bites can be potentially fatal when a person is allergic to the insect, such as with bee stings. 

Snake Bites

Signs and Symptoms

The bite site may be painless and without visible marks. Signs and symptoms of a snake bite may include:

• Paired puncture marks, but can be single or parallel scratches on the skin
• Headache
• Altered mental status – including confusion, irritation, or even unconsciousness
• Abdominal pain, nausea and vomiting
• Double or blurred vision or drooping eyelids
• Respiratory weakness or respiratory arrest
• Difficulty in breathing, speaking or swallowing
• Limb weakness, muscle paralysis
• In the bitten limb, swollen & tender glands (armpit/groin)

Management

You should first rest the casualty and reassure them as best as possible while investigating a potential snake bite. If found, follow the pressure immobilisation technique immediately and seek emergency medical assistance.

Pressure Immobilisation Technique (PIT)

• The bandage should be firm and tight (i.e., tight enough to prevent a finger from easily sliding between it and the skin) but not uncomfortable or painful.
• Next, bandage the entire limb (using an additional bandage or the same bandage if long enough)
• Start distally (furthest from the body) and work proximally (closer to the body) to reduce swelling.
• Once the limb is bandaged, use a splint to restrict any movement of the limb (i.e. a stick or pole, or if an upper limb, use a sling)
• Keep the casualty as still as possible and, ideally, assist them rather than attempt to move them.
• If the casualty becomes unresponsive, commence CPR

Pressure Immobilisation Technique (PIT) Video

DO NOT:

???? Do not cut, suck or treat the bitten area

???? Do not wash the bitten area

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The Pressure Immobilisation Technique is recommended for the following bites and stings:

• All venomous snakes
• Funnel-web spiders
• Blue-ringed octopus and cone shell

Remember: As first aiders, we don’t fix or diagnose; we only preserve life until more advanced care can be provided.

Spider Bites

Of the numerous species of spiders found in Australia, only two are capable of causing death: the funnel web and the redback spider (for a child).

It can be challenging to identify a funnel web, so any bite from a giant or black spider should be considered potentially dangerous.

Red Back Spider

Signs and Symptoms

• When bitten, instant pain at the bite site
  The bite site becomes swollen, red and hot
• Intense pain that spreads and increases
• Abdominal pain, nausea and vomiting
• Profuse sweating, particularly at the site of the bite
• In the bitten limb, swollen & tender glands (armpit or groin)

Red Back Spider: Treatment (Cold compress)

• Apply a cold compress to the affected area to help reduce swelling and pain for 20 minutes.
• Rest the casualty and monitor
• These are generally not fatal. However, the casualty should be directed to obtain a medical opinion.
• If pain is persistent, or the casualty experiences headache, nausea, vomiting, or an altered level of consciousness, then they should be taken to the hospital or call 000 for an ambulance.

Note: Do not apply the Pressure Immobilisation Technique (PIT), as the venom acts slowly.

Stings

Most stings should be treated with ice. If the casualty is allergic to the sting, there is a risk of anaphylaxis, which is a medical emergency. If an anaphylactic reaction occurs, follow the Anaphylaxis Guideline and DRS ABCD. Contact 000 immediately.

Bee Sting: Treatment (Cold compress)

• Never pull or squeeze the sting out, as more venom will be injected. Instead, try scraping it sideways away from the entry point.
• Apply a cold compress to the affected area for 20 minutes to help reduce swelling and pain (do not apply ice to the eye area).
• If the person is allergic to bee stings, they can fall into a life-threatening state of anaphylactic shock. The only treatment is an injection of adrenaline. Seek medical attention immediately

Most stings should be treated with ice. If the casualty is allergic to the sting, there is a risk of anaphylaxis, which is a medical emergency. If an anaphylactic reaction occurs, follow the Anaphylaxis Guideline and DRS ABCD. Contact 000 immediately.

Wasp: Treatment (Cold compress)

• Clean the affected area with soap and warm water
• Apply a cold compress to the affected area to help reduce swelling and pain for 20 minutes.
• Be alert for signs of anaphylaxis.
• Prolonged swelling at the site of the sting may respond to antihistamines – refer to the casualty for further advice

Fire Ants

Fire ants are dangerous, imported pests that could spread to large areas of Australia. They inflict a painful, fiery sting, which can, in rare cases, cause a severe acute allergic reaction (anaphylaxis). (excerpt from https://www.business.qld.gov.au)

Signs and Symptoms

• Fire ants inflict a fiery sting, which causes a small blister to form at the site of each sting after several hours
• Pain, burning and itching at the site
• Swelling of the stung area
• In allergic casualties:
  o onset of wheezing and breathing difficulties
  o facial swelling and hives
  o rapid pulse
  o collapse

Fire Ants: Treatment (Cold compress)

• Calm and reassure the casualty
• Apply a cold compress to the affected area to help reduce swelling and pain for periods of 20 minutes
• Gently wash the affected area with soap and water
• Leave the blisters intact; do not break them
• Rest the casualty and monitor
• Also, monitor the casualty for signs of an allergic reaction
  o If the onset of an allergic reaction:
  – Call Triple Zero (000) for an ambulance
  – Follow anaphylaxis treatment guidelines
  – Follow DRS ABCD and be prepared to perform CPR

Blue Ringed Octopus

Treatment: (PIT)

• Treatment for a Blue Ringed Octopus bite is the same as a snake bite
• Apply the Pressure Immobilisation Technique (PIT) and call 000 for an ambulance
• If the person stops breathing, follow DRS ABCD and commence CPR immediately

Box Jellyfish

The box jellyfish is equipped with millions of stinging cells extending from its body, which can potentially inflict fatal stings on humans. It can grow up to 38cm across the bell and has 60 tentacles, up to 15 at each corner.

In Australia, about 70 deaths in the past 50 years, none for nearly a decade.

Signs and symptoms of someone who has been stung by a Box Jellyfish include:

• Red welts – a variety of skin markings (frosted pattern)
• Tentacles left on the skin
• Severe pain around the lymph nodes (armpits, groin, etc.)
• Nausea, vomiting, headache
• Sudden cardiac arrest or respiratory distress

Box Jellyfish: Treatment (Vinegar)

• Carefully and safely remove the casualty from the water
• Observe DRS ABCD. Call 000 for an ambulance and be ready to perform CPR
• Flood the affected area with vinegar for 30 seconds to neutralise the tentacles
• If vinegar is not available, pick off any tentacles (this is not harmful to the first aider) and rinse the sting well with seawater
• For pain relief, apply a cold compress
• Rest the casualty, calm and reassure. Keep under observation

Note: Do not apply or allow fresh water directly onto the sting because it may activate and fire off undischarged stinging cells.

Bluebottle Jellyfish

The most common cause of jellyfish stings in Australia is Bluebottles, which vary in size. The severity of the sting is usually based on the amount of contact the tentacle had with the skin.

No fatalities have been confirmed in the Southern Hemisphere from these creatures. Most bluebottle stings are painful.

Signs and Symptoms

• Whip-like, red, wavy line on the skin from the tentacle
• Trails’ of blue ‘tentacles’ adhering to the body or limbs
• A red rash may occur
• Pain and stinging lasting several hours
• Allergic reactions are possible

Bluebottle Jellyfish: Treatment (Hot water)

• Rest the casualty, reassure and keep under observation
• Clear away the tentacles using seawater, then pick off any remaining tentacles (not harmful to the first aider)
• Immerse the stung area in hot water for 20 minutes to relieve pain
• The water should be as hot as the casualty can handle it
• Remember, your tolerance to heat may be different from the casualty.
• If hot water fails to relieve the pain, then try a cold compress
• Call 000 if pain persists, the stung area is quite large or is in a sensitive area such as the eye

Note: Do not rub the area that was stung. Do not treat with vinegar

Cone Shell

The Cone Shell is found in shallow water, sand flats, and reefs around Australia. Its brightly coloured shells resemble ice cream cones. The sting can ultimately lead to respiratory distress and death.

Basic Treatment:

• Treatment for a Cone Shell sting is the same as a snake bite
• Apply the Pressure Immobilisation Technique (PIT) and call 000 for an ambulance
• If the person stops breathing, follow DRS ABCD and commence CPR immediately (if you have undergone CPR training)

Ticks

Ticks can inject toxins that may cause local skin irritation or a mild allergic reaction. However, most tick bites cause few or no symptoms (generally develop over several days). In susceptible people (can occur within hours), a tick bite may cause an allergic reaction or even anaphylaxis, which can be life-threatening.

Basic Treatment:

• In the case of a tick bite, if there is no history of tick allergy, immediately remove the tick
• If the victim has a history of tick allergy, the tick must be killed where it is rather than removed
• If an anaphylactic reaction occurs, follow the Anaphylaxis Guideline
• Follow DRS ABCD, which can be learned through any first aid course. Contact 000 immediately for an ambulance
• Apply a cold compress to the affected area to help reduce swelling and pain for periods of 20 minutes
• Rest the casualty, reassure and keep under observation
• If the casualty has no history of tick allergy, take the casualty to a doctor to remove the tick

To kill the tick where it is:

• For small ticks (larvae & nymphs), use permethrin cream (available at pharmacies)
• Adult ticks should be frozen with an ether-containing spray (available at pharmacies).
• Please wait for the tick to drop off or remove it, taking the utmost care not to compress the tick (as this will squirt allergen, toxin and possibly infection into you)

Note: Do not use tweezers