Component Task: Responding to Childhood Emergencies: Bites and Stings

This is the act of giving immediate intervention by the Paediatric nurse/nurse to a child who has sustained a bite/sting/scratch from an animal, a plant or a human being. The management will be based on the type of agent.

Aims

·         Prevent shock

·         Control pain

·         Relieve discomfort

·         Restore health

·         Prevent complications

·         Allay fear and anxiety

Types

·         Scorpion stings

·         Bee stings

·         Wasps stings

·         Snake bites

·         Dog bites

·         Spider bites

·         Human bites

Requirements

a.      Oxygen apparatus (cylinder, mask/nasal pump)

b.      Suction tube/machine

c.      Ambu bag or self inflating bag

d.      Cannula and giving set

e.      IV fluids

f.        Syringes and needles

g.      Glucometer and strips

h.      Appropriate pain scale

i.         Glasgow coma scale

j.         Anti-venom

k.       Tetanus toxoid

l.         Anti-histamine

m.   Pain medication

n.      Thermometer

o.      BP apparatus

p.      Watch/timer

q.      Paediatric stethoscope

r.        Sterile dressing pack

s.       Tourniquet

Steps

1.        Receive child into the emergency couch

2.      Introduce self quickly to child and caregiver

3.      Assess the site of the sting or bite

4.      Determine the type of sting or bite

5.      Call for resuscitation tray and assistance

6.      Perform five moments of hand hygiene as and when required

7.       Ensure bed rest, keep child/caregiver calm, warm and reassure

8.      Immobilize or splint the affected limb

9.      Assess airway, breathing and circulation

10.    Clear airway if necessary

11.      Loosen tight clothing

12.    Administer oxygen, intubate and provide ventilatory support if necessary

13.    Clean site with antiseptic lotion or soap and water if it is a bite

14.    Obtain weight on admission

15.    Provide IV access

16.    Administer prescribed medication:

·         Anti-venom/anti-rabies

·         Analgesic

·         Anti-histamine/steroids

·         Anti-tetanol serum

·         Antibiotics

·         Anti-convulsant

17.    Assess and treat for shock

18.    Assess level of consciousness

19.    Assess blood sugar level and manage appropriately

20.  Dress wound aseptically using prescribed topical antimicrobial dressing

21.    Assess the level of pain and manage

22.  Monitor vital signs (TPR, BP, O2 Saturation and pain) fifteen (15) to thirty (30) minutes for the next two (2) hours

23.  Explain procedure to child and caregiver

24.  Document all procedures, findings and observations in the appropriate charts (manual or electronic)