000 Ambulance
Call for any suspected snake bite, a big black spider (possible funnel-web), a box jellyfish or Irukandji sting, a blue-ringed octopus or cone shell, a stonefish or stingray, or signs of a severe allergic reaction. If the person is unresponsive and not breathing normally, start CPR. Source: ANZCOR 9.4.1; ANZCOR 9.4.2; ANZCOR 9.4.5
Advice: Poisons Information 13 11 26 (24/7). Source: NSW Poisons Information Centre; healthdirect, jellyfish
Which first aid?
| Treatment | Use for | Not for |
|---|---|---|
| Pressure bandage + splint (how) | All Australian snakes incl. sea snakes, funnel-web spider, blue-ringed octopus, cone shell | Redback and other spiders, jellyfish, stonefish and other fish, scorpions, centipedes, beetles |
| Vinegar, 30 seconds | Box jellyfish and Irukandji (tropical waters) | Bluebottles |
| Hot water, as hot as tolerable without burning | Bluebottle, stonefish, stingray | |
| Ice / cold pack | Redback and other spiders, bee and wasp stings, other jellyfish | Bluebottle, stonefish, stingray, ticks |
Pressure bandage with immobilisation
- Apply a broad pressure bandage over the bite site as soon as possible (elastic, 10 to 15 cm wide, is best; otherwise crepe, clothing or other material). It should be firm and tight: you can't easily slide a finger between bandage and skin.
- Apply a second bandage from the fingers or toes upward, covering as much of the limb as possible. Bandage over clothing.
- Splint the limb, including the joints on either side of the bite. A sling for an arm bite.
- Keep the person and limb completely still. Bring transport to them; ambulance preferred. Don't remove bandages or splints until at hospital.
- Bite not on a limb: firm direct pressure on the site may help. Don't restrict breathing or chest movement, and don't press on the neck or head.
Snakes
All snake bites must be treated as potentially life-threatening. Dangerous groups include brown snakes, tiger snakes, taipans, death adders, black snakes, rough-scaled snakes and sea snakes. Source: ANZCOR 9.4.1; healthdirect, snake bites
Signs (the bite may be painless)
- Fang marks, often just one mark or a scratch
- Headache, nausea, vomiting, stomach pain
- Blurred or double vision, drooping eyelids
- Difficulty speaking, swallowing or breathing
- Swollen tender glands in groin or armpit
- Limb weakness or paralysis, breathing failure
Collapse with cardiac arrest can happen 10 to 60 minutes after the bite and needs immediate CPR. A brown snake bite may cause collapse or confusion followed by apparent recovery. There is no risk of venom reaching a rescuer through CPR.
Do
- Call 000 for an ambulance.
- Keep the person still, reassured and watched constantly.
- Pressure bandage and splint.
- CPR if unresponsive and not breathing normally.
Don't try to catch or kill the snake (risk of more bites; many are protected). A photo, if safe, may help identification. Source: ANZCOR 9.4.1
Avoid bites: back away and let a snake move off. Use a torch at night, make noise and watch where you step, sit or put your hands in the bush, and wear jeans and boots. Source: healthdirect, snake bites
Spiders
Funnel-web: big black spider
A bite from a large (over 2 cm), dark spider is dangerous, especially in Sydney, the Blue Mountains, the central, northern and southern highlands or south coast of NSW, and south-east Queensland. It can be life-threatening within 10 minutes; antivenom exists.
- Call 000.
- Pressure bandage and splint; keep the person still.
- CPR if they collapse.
Don't bring a live spider to hospital. A phone photo may help, but don't let it delay first aid.
Redback
About 1 cm, with a red, orange or pale stripe on the back. Pain spreads and may bring sweating, nausea, vomiting and stomach pain. It can threaten the life of a young child; in adults it is rarely serious apart from pain. Serious illness is unlikely within 3 hours.
- Ice or a cold compress, no more than 20 minutes at a time. No pressure bandage.
- Medical care, preferably by ambulance, for a young child, collapse or severe pain.
Other spiders (including white-tail)
Ice pack for pain. Medical care if unwell; hospital if serious symptoms develop.
Avoid bites: leave spiders alone, wear gloves when gardening, check shoes before putting them on. Source: healthdirect, spider bites
Box jellyfish and Irukandji
Dangerous jellyfish mainly occur in tropical waters, from about Bundaberg (Qld) north and around to Geraldton (WA). Irukandji have been reported as far south as Port Phillip Bay. Stinger season is typically late spring to early autumn. Source: ANZCOR 9.4.5; healthdirect, jellyfish
Recognise
- Box jellyfish: immediate severe pain; whip-like, “frosted ladder” marks. A bad sting can stop the heart.
- Irukandji: a minor sting, then 5 to 40 minutes later (typically 20 to 30) severe generalised pain, nausea, sweating, breathing difficulty, a sense of impending doom.
Do
- Get the person out of the water. Call 000. CPR if unresponsive and not breathing normally.
- Pour vinegar on the sting for 30 seconds. No vinegar: rinse with sea water, never fresh water.
- Pick off any remaining tentacles.
- Cold pack for pain.
Avoid stings: swim at patrolled beaches, stay out when there are warnings, wear a full-body wetsuit or stinger suit. Source: healthdirect, jellyfish
Bluebottle
- Pick off tentacles and rinse with sea water. No vinegar.
- Bathe the stung area in hot water, 43 to 45 °C, for up to 30 minutes (check the person can tolerate it and it doesn't burn). If heat doesn't help or there is no hot water, a cold pack or ice in a dry plastic bag. Don't rub the sting.
- Ambulance if pain persists or spreads, the sting covers half a limb or more, or the eye is involved.
Blue-ringed octopus and cone shell
Found in Australian coastal waters and rock pools. The bite is often painless (a spot of blood), then numb lips and tongue and weakening breathing muscles; paralysis and death from breathing failure can happen within 30 minutes. The person may still hear you even if they can't move. Source: ANZCOR 9.4.5; healthdirect, sea creatures
- Call 000.
- Pressure bandage and splint, keep still.
- CPR if unresponsive and not breathing normally.
Stonefish and stingray
- Call 000.
- Don't pull out an embedded barb: pad around it and press over the pads. Sting to the chest or belly: check for bleeding (spines can go deep).
- Put the stung hand or foot in hot water, no hotter than the rescuer can comfortably tolerate.
- No pressure bandage, no cold pack.
Stonefish antivenom exists.
Crocodiles
Estuarine crocodile habitat runs from near Gladstone north to the Torres Strait, Cape York and the Gulf of Carpentaria, in any waterway and the sea. No waterway in their range can be considered croc-free. Attacks can happen at any time of year. Source: Qld Government, Be Crocwise
Be Crocwise
- Keep out of the water, even shallow water for a short time.
- Stay more than 5 m from the water's edge.
- If you must approach, keep a sturdy object (esky, stump, rock) between you and the water; don't crouch, and never use the same spot twice.
- Supervise children; keep pets on a lead and away from the edge.
- Take extra care at night, dusk and dawn.
- Bin or take home food scraps, fish scraps and bait.
- Stay away from croc traps, nests, tracks and slide marks.
Ticks
Ticks are especially common along the east coast. The main danger is a severe allergic reaction. Source: healthdirect, ticks
- Don't squeeze, twist or pull the tick off, and don't use tweezers.
- Adult tick: freeze it with an ether-containing spray (from a pharmacy) and let it drop off.
- Larvae and nymphs: permethrin cream (not near eyes, ears or genitals).
- No cold compress for ticks.
- Allergic before? Carry and use your adrenaline autoinjector. Remote areas: seek medical advice.
Avoid bites: cover up (sleeves tucked in, trousers into socks, wide hat), light-coloured clothes, repellent with DEET, picaridin or lemon eucalyptus; avoid long grass after rain; check skin and put clothes in a hot dryer for 20 minutes. Source: healthdirect, ticks
Source: ANZCOR 9.4.3; healthdirect, ticksBees and wasps
Severe allergy (anaphylaxis)
Signs: difficulty breathing or noisy breathing, swollen tongue or throat, wheeze or persistent cough, voice change, dizziness, stomach pain, vomiting, collapse.
Use the adrenaline autoinjector immediately, then call 000. Follow the person's allergy action plan. Also call 000 for multiple stings to the face or tongue.
- Bee sting: scrape the sting out quickly (fingernail edge or a card) without squeezing the venom sac.
- Cold compress for pain.