Paediatric Nursing (PAED)
RESPONDING TO CHILDHOOD EMERGENCIES: BITES AND STINGS
This is the immediate management of insect bites, animal bites, and stings in children.
Purpose
- Remove stinger if present
- Clean and treat wound
- Manage pain and swelling
- Prevent infection
- Monitor for allergic reactions
- Prevent tetanus
Indications
- Child presenting with insect/animal bite or sting
Equipment
- Gloves and PPE
- Tweezers or forceps
- Soap and water
- Antiseptic solution
- Cold compress
- Topical corticosteroids
- Antihistamines
- Epinephrine auto-injector (for anaphylaxis)
- Tetanus prophylaxis
- Wound dressing materials
Preparation
- Prepare emergency equipment
- Have epinephrine readily available
- Assess allergy history
Procedure steps
- Ensure scene safety
- Put on gloves
- Remove child from source of bites/stings
- Remove stinger by scraping (not squeezing)
- Wash area with soap and water
- Apply cold compress
- Elevate affected limb
- Apply topical treatment
- Administer oral antihistamine if needed
- Administer pain relief
- Assess for signs of anaphylaxis
- Administer epinephrine if anaphylaxis present
- Update tetanus immunization if needed
- Apply sterile dressing if wound present
- Monitor for infection
- Educate on prevention
Precautions
- Watch for signs of anaphylaxis
- Do not squeeze venom sacs
- Monitor for infection
- Consider rabies risk with animal bites
Aftercare
- Monitor site for 24-48 hours
- Watch for delayed reactions
- Ensure follow-up if needed
- Provide wound care instructions
Nursing considerations
- Assess for multiple stings
- Consider age-appropriate pain management
- Evaluate need for reporting animal bites
- Address child's fears
Patient education
- Teach avoidance strategies
- Explain signs of infection
- Describe allergic reaction symptoms
- Demonstrate epinephrine use if prescribed
Documentation
- Type and location of bite/sting
- Time of incident
- Treatment provided
- Child's response
- Tetanus status
- Education given
References and further reading
Educational resource only. Follow current Nursing and Midwifery Council guidance, local institutional protocols, scope of practice, and clinical supervision.
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