Insect Bites, Stings, and Pediculosis Describe the etiology and epidemiology of insect bites and explain the pathophysiology and signs/symptoms of various insect bites. o Mosquitoes Malaria, west nile, yellow fever and Zika Virus o Fleas Body warmth and exhaled CO2 attract Bites Usually multiple and grouped on legs and ankles o Sarcoptes Scabiei Scabies “the itch” Mites burrow into stratum corneum to start a new life cycle Common infestations sites are within skin folds Char: inflammation and intense itching o Bed Bugs o Ticks Remains attached to host up to 10 days Use tweezers to remove DO NOT USE irritants to help removal Lyme disease—deer tick o Doxycycline DOC o May also use amoxicillin, ceftin, or rocephin Ehrlichiosis—lone star tick o Doxycycline Rocky Mountain Spotted Fever o Doxycycline Tularemia Anaplasmosis Babesiosis o Chiggers “Redbugs” o Spiders Explain the complications of the various types of insect bites. o Secondary Bacterial Infections Scratching of the skin o Impetigo infections Yellow crusting Purulent drainage Redness and swelling Recommend appropriate treatment regimens for insect bites given a set of patient specific data. o Prevention Avoidance of insects
Insect repellents Useful in preventing bites from insects Not effective in repelling stinging insects (wasps, bees, hornets) DEET o Releases vapors to discourage the approach of insects o Concentrations 7-100% >20% to prevent tick bites <30% preferable for children 10-40% routine situations 50-100% adults with high exposure to insects Higher chance of skin reactions o Avoid in children younger than 2 months o Administration: Apply to skin or clothing every 4-8 hours (depending on product) Do not apply under clothing Do not apply to broken or irritated skin If wearing both: Sunscreen then repellent FDA recommends against sunscreen + DEET products o A/E Skin irritation CNS reactions with overdose and improper use Seizures Ataxia Hypotension Angioedema Picaridin 7% o Colorless and odorless insect repellent o EPA recommends as an alternative to DEET Odorless and less irritating to skin o Treatment of insect bites Ice pack Apply external analgesic Avoid scratching skin Trim fingernails in children o Exclusions for Self-Treatment Hypersensitivity to insect bites—systemic symptoms <2 years of age History of tick bits and systemic effects indicating possible infection Severe spider bites requiring medical attention Sign sod secondary infection of the bite area. o Treatment of pain and itching for insect bites Local anesthetics
MOA: causes a reversible blockade of conduction of nerve impulses at the site of application—producing loss of sensation Indications: o Burns, o Sunburns, o Minor cuts o Insect bites o Minor skin irritation to relieve pain and itching Dosage and administration o Applied directly to insect bite 3-4x/day o MAX duration 7 days Safety considerations o Relative non-toxic when applied as directed o
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- Spring '17
- Head louse, Irritation, Pediculosis, Body louse, Louse, Mites