Monthly Archives: August 2015

Spider bites

Both spiders and ticks are common in our area. We’ll deal with ticks next time.

While most of their bites aren’t dangerous to most people, it’s good to be informed about different types of spiders, their bites, and diseases that might result from some of them.

Spiders use a venom to anesthetize and paralyze their tiny prey. The venom from most species is not dangerous to most humans (see below for exceptions). Watch for signs of infection and report those immediately to your pediatrician. If you are concerned that a bite is getting much larger, note the edges with a Sharpie marker so you can see if it’s continuing to grow.

The female black widow spider can be extremely poisonous to humans, sometimes even fatal. She has an hourglass shape and is dark colored with yellow or red on her abdomen. Symptoms can be severe muscle cramping and pain. Call EMS if you think someone has been bitten by a black widow spider.

The brown recluse spider is fairly common in Kentucky, and can also be fatal at times. People often don’t know they’ve been bitten until the bite starts to swell and get painful. Reactions greatly vary. Call EMS if you are concerned about a brown recluse bite.

According to this article by the American Academy of Pediatrics (AAP), here are things to watch for after a spider bite, and a signal to call your pediatrician or EMS:
• “Tiny fang marks
• Pain
• Pain begins as a dull ache at the bite site
• Pain spreads to the surrounding muscles
• Pain moves to the abdomen, back, chest, and legs
• Blister at the bite site
• Mild swelling and a blue-gray mark at the bite surrounded by lightening of skin color
• Progressive soft tissue damage; the skin becomes dark blue and then black (necrotic).”

Wash the affected area with soap and water, and treat a bite with an ice pack (make sure you put a layer of cloth between the ice pack and the skin) Another resource for your questions about spider bites is the Poison Control Center.

As with anything, whenever you have a concern, call our office.

© MBS Writing Services, 2015, all rights reserved

Stinging insects

Nothing quite puts a damper on outdoor fun like a sting from a bee, yellow jacket, hornet, or wasp.

Art by Corinne

Art by Corinne

While most stings, though annoying and painful, aren’t dangerous, sometimes they can be severe in certain cases.

First things first – how to avoid getting stung:

  • Check the spots where your child plays for nests of stinging insects. Nests can be in trees or bushes, on structures like houses and barns, under picnic tables or by the porch. If you see an unusual number of the same type of stinging insects in one area, it’s possible there is a nest nearby. Once you’ve located a nest, you should consider calling an exterminator. If it is a honey bee hive, locate a beekeeper who will almost certainly be interested in collecting a new hive, and who knows how to do that safely. On rare occasions you might see a honey bee swarm. This occurs when a hive has gotten too large and is in the process of dividing. Be very careful to avoid the swarm and call a beekeeper immediately.
  • Wear shoes outdoors. Even sandals or flip-flops are not good protection from stinging insects hiding in the grass.
  • Wear light-colored clothing, and don’t wear anything with a floral pattern. Bees can be attracted to that as if it were a real flower!
  • Watch what you eat outside. Insects are attracted to sweet foods and beverages and other food items like peanut butter.
  • Don’t allow your child to touch even a dead stinging insect; the stinger still contains venom.
  • As difficult as it may be, don’t swat at an insect because that may make it attack.
  • Read about these and other preventative measures in this article by the American Academy of Pediatrics. The article contains this additional warning: “If you have disturbed a nest and the insects swarm around you, curl up as tightly as you can to reduce exposed skin. Keep your face down and cover your head with your arms.”

So, what to do after a sting?

If the child or adult is highly allergic to stings, watch closely for signs of anaphylaxis. Another article by the AAP describes an anaphylactic reaction like this:

  • “A severe life-threatening allergic reaction is called anaphylaxis.
  • The main symptoms are difficulty breathing and swallowing starting within 2 hours of the sting.
  • Anaphylactic reactions to bee stings occur in 4 out of 1,000 children.
  • The onset of widespread hives or facial swelling alone following a bee sting is usually an isolated symptom, not the forerunner of anaphylaxis. Your child’s doctor will decide.”

In the case of anaphylaxis, administer epinephrine in the form of an EpiPen or AUVI-Q, if available, and call 911.

More common reactions to stings are redness and swelling, pain and itching.

If the stinger is in the skin (only honeybees leave their stingers behind), scrape it out with your fingernail, or if it’s completely under the skin just leave it alone and it will be shed naturally.

Here are the AAP’s recommendations for care after a sting:

  • “Meat Tenderizer:
    • Apply a meat tenderizer-water solution on a cotton ball for 20 minutes (EXCEPTION: near the eye). This may neutralize the venom and decrease pain and swelling.
    • If not available, apply aluminum-based deodorant or a baking soda solution for 20 minutes.
  • Local Cold: For persistent pain, massage with an ice cube for 10 minutes.
  • Pain Medicine: Give acetaminophen (e.g., Tylenol) or ibuprofen immediately for relief of pain and burning.
  • Antihistamine: If the sting becomes itchy, give a dose of Benadryl. (See Dosage chart)
  • Hydrocortisone Cream: For itching or swelling, apply 1% hydrocortisone cream to the sting area 3 times per day (No prescription needed).
  • Expected Course: Severe pain or burning at the site lasts 1 to 2 hours. Normal swelling from venom can increase for 24 hours following the sting. The redness can last 3 days and the swelling 7 days.
  • Call Your Doctor If:
    • Develops difficulty breathing or swallowing (mainly during the 2 hours after the sting) (call 911)
    • Redness lasts over 3 days
    • Swelling becomes huge or spreads beyond the wrist or ankle
    • Sting begins to look infected
    • Your child becomes worse
    • And remember, contact your doctor if your child develops any of the “Call Your Doctor” symptoms.”

© MBS Writing Services, 2015, all rights reserved

Sports physicals – it’s time

Your kids are on the move – literally, and all the time! If they are involved in a fall sport at school, then it’s time for their sports physical. Don’t forget that there is tremendous benefit to getting these physicals at your child’s pediatric office, rather than at a clinic or a school-sponsored physical day. The pediatrician has all your records including vaccinations, allergies, and your individualized and family medical history. He or she can discuss important sports information with you, including nutrition. And, of course, follow-up is always readily available, whether one week or six months from now. We are delighted to be working, with you as our partner, to make a medical home for your family here with us. If your child has a physical at a clinic or the school, that physical is not a part of our records, and we end up with an incomplete picture of his or her development and needs. Read our previous blog post for more reasons on why it’s wise to bring your child to the pediatrician when it’s time for a physical.

© MBS Writing Services, 2015, all rights reserved