Bites, stings, heat, cold and drowning

Australian envenomation

For suspected Australian snakebite, keep the person still, call emergency help and apply pressure immobilisation according to ANZCOR, including immobilising the limb. Do not let the patient walk, wash the bite, cut it, suck venom or apply a tourniquet. An initially well patient may deteriorate; urgent hospital assessment and serial observation/testing are needed. Identification should not put anyone at risk by attempting to catch a snake. The bite appearance and absence of pain do not reliably establish that no envenomation occurred.

Hospital assessment considers coagulopathy, neurotoxicity, myotoxicity and renal injury, with toxicology advice about antivenom and monitoring. Do not remove a pressure bandage casually in an unprepared setting. Antivenom selection depends on the clinical/exposure assessment and current protocol, not a lay identification alone. First-aid instructions for pressure immobilisation do not apply to every animal bite. The distinctions matter because treatment of one species can be inappropriate for another.

Spiders, marine injury and anaphylaxis

Suspected funnel-web bite needs emergency help and pressure immobilisation; redback bite uses a different pain-focused first-aid pathway, with antivenom decisions made clinically. Do not apply one generic “Australian spider” protocol. Marine first aid is species and location dependent: tropical potentially lethal jellyfish, bluebottle, blue-ringed octopus, cone shell and fish-spine injuries have different measures. Prioritise resuscitation when collapse occurs and follow current ANZCOR marine guidance. Avoid blanket vinegar or pressure-bandage advice for every beach sting.

Bee, wasp, ant or tick-related symptoms can trigger anaphylaxis. Sudden airway/breathing/circulatory compromise after an exposure requires prompt IM adrenaline, help and monitoring, even without a rash. Position the patient appropriately and do not allow sudden standing. Tick removal in someone at risk of tick anaphylaxis requires the current specific advice and emergency preparedness; squeezing or disturbing a tick can provoke harm. Local swelling alone differs from systemic anaphylaxis, but ongoing observation and return advice depend on the presentation.

Animal and human bites

Assess depth, location, tendon/joint involvement, neurovascular status and contamination. Hand wounds and clenched-fist injuries can seed joints/tendons and need urgent specialist assessment. Irrigation, selected debridement, tetanus review and antibiotics follow wound/organism risk, not one regimen for all bites. Cat punctures can be deep despite a small surface mark. A bite over a joint with pain on movement is not a simple cosmetic injury. Consider safeguarding and assault context privately when the mechanism is unclear.

Rabies or Australian bat lyssavirus exposure needs immediate wound care and expert post-exposure assessment. Contact with bats should not be dismissed because an obvious bite cannot be seen. Vaccine and immunoglobulin decisions depend on exposure, previous vaccination and the current pathway. Do not wait for symptoms before referring; established disease is usually devastating. Document the animal, location, contact details and time, and coordinate with public health. Travel and wildlife exposures can introduce risks unfamiliar to a routine local wound protocol.

Heat and cold

Heatstroke involves serious heat illness with central neurological dysfunction and requires immediate cooling and emergency care. Remove from heat, assess ABCs and use effective active cooling while monitoring; antipyretics do not treat this mechanism. Exertional and classic presentations differ, and organ injury may develop despite temperature improvement. Assess electrolytes, renal/liver function, coagulation and rhabdomyolysis according to severity. Mild heat exhaustion should not be assumed when confusion, collapse or severe systemic symptoms are present.

Hypothermia can cause altered consciousness and arrhythmia. Handle gently, prevent further heat loss and use the appropriate rewarming/resuscitation pathway. Avoid a casual declaration of death based on apparent inactivity without proper cold-exposure assessment. Wet clothing, wind, immersion, intoxication and age contribute to risk. Frostbite needs protection and specialist advice; rubbing or thawing tissue that may refreeze can worsen injury. Hypothermia care differs from treating a fever or giving a sedative to stop shivering without assessment.

Drowning and applied choices

Remove from danger without endangering rescuers, call for help and provide breathing/CPR support. Ventilation matters because drowning arrest is commonly hypoxic; do not spend time trying to drain water from the lungs. Hypothermia, trauma and pulmonary injury need assessment. A person with respiratory symptoms after immersion requires medical review even if briefly improved. Do not give routine prophylactic antibiotics for every drowning; contamination and infection findings guide decisions with the relevant pathway.

A possible snakebite in a well person needs stillness, pressure immobilisation and emergency assessment. A confused runner collapsing in heat needs immediate cooling and resuscitation. A small human bite over a knuckle needs deep-structure assessment. These situations test mechanism-specific first aid and recognition of occult danger. Document actions and times, including cooling or bandaging, and hand over exposure uncertainties rather than presenting a guessed species as fact.

ANZCOR first aid and pressure immobilisation.

Review checkpoints

• For suspected Australian snakebite, immobilise and use pressure immobilisation without washing the bite.
• Do not let a suspected snakebite patient walk to seek help.
• Severe heat illness requires urgent cooling and emergency assessment.