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BITES BURNS BLOOD: First Aid for Skin Issues Resulting from Being Outdoors

Whether you find yourself outdoors for your job, livelihood, as a weekend warrior, for recreation or mental well-being, or as a spectator, you may end up with an injury resulting from a bite or burn or an injury creating a bloody situation. This document will provide first aid basics to address skin-related injuries resulting from being outdoors. Simple home remedies and guidance for when you need to seek a professional medical provider are provided below.

NOTE: This factsheet summarizes some common injuries, is NOT intended to be all-inclusive, and does not include ingestion or eye concerns. Call poison control at 1-800-222-1222  in cases of ingestion. This information does not replace professional medical advice. Refer to medical professionals anytime you have concerns, and call 911 for any emergencies. While over-the-counter products are referred to in this factsheet, DO NOT take or use any substances that are known to cause the individual an allergic reaction.

Bites

Bugs, snakes, animals (including aquatic), human bites, and rashes: There are a variety of types of bites (or stings) that can occur when spending time outdoors. A bite is defined as an injury in which the body surface is torn by an insect or animal, resulting in abrasions (scraping away of the skin). Some bites (or stings) can lead to a rash. The seriousness of a bite varies; therefore, contact 911 if unsure.

  • Mosquito/bug bites result in itchy bumps after they feed on your blood (Mayo Clinic). The bumps usually go away without treatment in a few days. Bites, including those from ticks, may result in a rash. More information on this can be found below.
  • Stings from bees, wasps, hornets, fire ants, and jellyfish can cause discomfort. Some stings can cause an allergic reaction. So, pay close attention to the breathing of the person that was stung. With fire ants, brush the ants off. Fire ant bites sting when the ant injects venom. Red bumps or welts may form at the sting and will sometimes become fluid-filled pustules. The area of the sting may become warm.
  • Animal (including snake and human) bites will usually leave marks on the skin at the bite site. Bites from a venomous snake, shark, or alligator warrant a call to 911. Not all bites will appear the same nor require the same action. The source of the bite (examples: dog, cat, horse, shark, alligator, human) will dictate what response is needed. Animal and human bites should be treated in accordance with their severity. Poisonous snakes have fangs that leave marks on the skin that will appear as 1-2 puncture wounds. If poison is injected, the bite will burn within 5 minutes and will begin to swell within 30 minutes.

Bite Treatment:

  • Self-treat (DO)
    • Remain calm
    • Call 911 if there is severe bleeding, if it is a snake bite from a venomous snake, or if it involves a shark or alligator
    • Call 911 if an insect or jellyfish sting causes chest pain, nausea, severe diarrhea/vomiting, severe sweating, loss of breath, serious swelling, slurred speech or any severe allergic reaction
      • If the individual stung has a known allergy to insects, use the individual’s prescribed EpiPen
    • If a major bite and severe bleeding, apply pressure with a bandage or clean cloth
      • Maintain the person’s airway; use CPR if necessary
    • If a minor bite, clean the bite with soap and water, apply an antibiotic cream or ointment and cover or wrap it loosely with a clean, dry bandage
    • If stung by an insect, wash the area with soap and water, remove the stinger using gauze wiped over the area or by scraping a fingernail over the area, and apply ice to reduce swelling
    • If stung with fire ants, brush the ants off
    • If stung by a jellyfish, use tweezers to remove visible tenacles, use vinegar on the area, soak the affected area in warm water (110° to 113° F) for 20 to 45 minutes, and apply 0.5% to 1% hydrocortisone cream or ointment twice a day to the affected area
    • Move far away from the source of the bite (bug, snake, animal)
    • Remove jewelry & watches before swelling starts
    • Sit or lie down so that the bite is in a comfortable position
    • Apply ice if you observe swelling (except for snake bites – DO NOT USE ICE FOR SNAKE BITES)
  • Self-treat (DON’T)
    • Don’t use a tourniquet
    • Don’t scratch at the area
    • Don’t apply ice to a snake bite
    • Don’t cut a snake bite or try to remove venom
    • Don’t squeeze the stinger or use tweezers for an insect sting
    • Don’t take aspirin, ibuprofen (Advil, Motrin IB) or naproxen sodium (Aleve) for a snake bite
  • Complications
    • Mosquito bites can cause severe illnesses if the infected insects carry certain viruses (West Nile, Zika)
    • All bites have a risk of infection
  • Prevention
    • Use bug spray
    • Avoid perfume and scented products
    • Wear long-sleeved shirts, long pants, socks, closed-toe shoes, and boots; this can help prevent contact with plants like poison ivy, as well as protect against ticks and other bites
    • Take care when moving a stationary object that has been sitting outside as bugs and animals, and hidden plants may be present underneath
    • Always be aware of your surroundings
    • Have a first aid kit available at home and when traveling
    • Travel with a buddy when possible
    • Keep vaccinations up to date
    • Avoid being in the water with sharks during darkness or twilight hours when they are most active
    • Remove shiny jewelry before entering water with sharks as shiny jewelry can look like fish scales, which is appealing to sharks
  • When to seek professional medical help:
    • Call 911 if there is severe bleeding
    • Call 911 for bites from a venomous snake and bites from sharks & alligators
      • If possible, describe the snake to the healthcare professionals
      • If possible, take a picture from a safe distance
    • Call 911 if an insect or jellyfish sting causes chest pain, nausea, severe diarrhea/vomiting, severe sweating, loss of breath, serious swelling, slurred speech or any severe allergic reaction
      • If the individual stung has a known allergy to insects, use the individual’s prescribed EpiPen
    • Seek out a health care provider when symptoms include a high fever, severe headache and body aches
    • Note: some bites may require tetanus and/or rabies shot and/or need medicine (such as antibiotics) to fight infection (if you don’t know if you have had your childhood scheduled tetanus shots, got your last tetanus shot less than10 years ago, or have had less than 3 lifetime doses of tetanus shot see a medical provider)
    • Keep a healthcare professional’s contact information available on your phone, provide healthcare professionals with as much information as possible, and keep
    • a list of medications currently taking (prescribed and over the counter) with you or on your phone

Insect sting.

Insect sting.
Credit: @isengard-stock.adobe.com

Snake bite.

Snake bite.
Credit: @marketlan-stock.adobe.com

Rashes

A rash can result from a bite, plant, allergy, chemical, drugs or medication, illness or infection, or other sources, including a hot environment. Rashes are red and inflamed skin, which can be associated with significant discomfort, pain, and annoyance. A rash may simply present as a change in skin texture, with or without discomfort or itching, and may or may not have a change in skin color. Rashes can be a sign of an underlying medical issue or disease; various medical conditions can present with a rash. Therefore, careful evaluation of a rash and associated symptoms is important in determining the best course of action for management. During the warmer months, a rash that typically appears on areas of the skin that have hair can get worse with increased sweat and exposure to heat sources. These areas include the scalp, face, and eyebrows (dandruff) and can be caused by an overgrowth of fungi on the skin, leading to greasy red patches of skin that appear inflamed and itchy.

  • Tick bites can occur when outdoors and can be a common cause of new rashes in the warmer months. Lyme disease is spread by Ixodes deer ticks and is more common in the northeastern United States. A common feature of this disease is a bull’s eye rash. Rocky Mountain Spotted Fever is another tick-borne illness spread by the Dermacentor or dog tick and is more common in the southern United States. The rash associated with this infection typically begins on the hands and feet, specifically impacting the palms and soles.
  • Skin contact with a variety of things associated with going outdoors, including cosmetic products (lotions, sunscreen, bug spray), soaps, chemicals, latex, dyes, plants (poison ivy, oak, sumac), and heat, can result in a rash. This type of rash can begin with itchy bumps or an area of redness that moves on to form blisters, which can later pop.
  • Allergens can cause a rash that can be extremely itchy and uncomfortable and may turn scaly. Contact with allergens can also lead to hives, which are raised oftentimes large welts that can occur all over the body.
  • Infections are another cause of rashes. These can be indicative of a more serious medical issue, so careful evaluation of a suspected infection should be done by a medical professional.

Rash Treatment:

  • Self-treat (DO)
    • If you can identify the cause of a rash, avoiding additional skin contact can resolve symptoms
    • Showers following activity in the heat can help alleviate itching and redness
    • Common over-the-counter treatments for rashes include:
      • Allergy medications, such as antihistamines, can help reduce itching and provide some relief; however, they may be associated with drowsiness
      • Anti-inflammatory creams, such as hydrocortisone, contain steroids which can help with symptoms
  • Self-treat (DON’T)
    • Don’t scratch at itchy skin, as it is crucial to maintain wound integrity and to prevent new skin infections; constant scratching can lead to tears in the skin, leading to colonization of impacted areas with bacteria
  • Complications
    • Tick bites can lead to symptoms such as facial nerve palsy, migratory arthritis, and heart inflammation, and diseases such as Lyme and Rocky Mountain Spotted Fever
  • Prevention
    • Use bug spray
    • Avoid perfume and scented products
    • Wear long-sleeved shirts, long pants, socks, closed-toe shoes, and boots; this can help prevent contact with plants like poison ivy, as well as protect against ticks and other bites
    • Take care when moving a stationary object that has been sitting outside as bugs and animals, and hidden plants may be present underneath
    • Always be aware of your surroundings
    • Have a first aid kit available at home and when traveling
    • Travel with a buddy when possible
    • Keep your vaccinations up to date
    • Wash hands frequently, especially after encountering known allergens
  • When to seek professional medical help:
    • Call 911 and/or go to the Emergency Room if you develop symptoms of anaphylaxis, including throat and mouth swelling, hives, and difficulty breathing (This is a potentially fatal complication that requires immediate management with an EpiPen)
    • A rash with a new onset fever, headache and/or severe symptoms
    • A rash with the formation of new blisters or open sores, draining pus, worsening pain and redness, or spread of the rash beyond original boundaries to new areas
    • If you observe a bull’s eye rash or a rash on the hands and feet, specifically impacting the palms and soles, from a tick bite
    • Infections may require antibiotic treatment
    • Keep a healthcare professional’s contact information available on your phone, provide healthcare professionals with as much information as possible, and keep a list of medications currently taking (prescribed and over the counter) with you or on your phone
      • One of the most important things to note is when the onset of the rash began. This can change the course of treatment and may be helpful in determining the course of action. Additional information to note: possible triggers or causes, if identifiable, and any treatment options that have been attempted thus far. Using this information, a provider may elect to wait for your body to resolve the issue itself, pursue treatment options, or refer you to another provider, such as a Dermatologist or Allergist.

Lyme disease rash.

Lyme disease rash.
Credit: @dennisjacobsen-stock.adobe.com

Poison Ivy rash.

Poison Ivy rash.
Credit: @Michael Moloney-stock.adobe.com

Infected skin wound.

Infected skin wound.
Photo credit: Deboro-stock.adobe.com

Burns

Sun, fire, steam/hot liquid, chemical, electrical, and cold: Various types of burns can occur when spending time outdoors.

  • Sunburn is inflamed, painful skin from too much exposure to UV light (ex., the sun, tanning beds). The UV light damages skin cells and can cause inflamed skin, pain, swelling, small fluid-filled blisters, and more, depending on the severity of the burn.
  • Burns from fire, steam, or hot liquid (including grease) cause tissue damage due to exposure to fire, steam, or a hot liquid and can appear red, blister, or cause skin sloughing depending on the degree of burn.
  • Chemical burns cause tissue damage caused by chemicals such as pesticides, ammonia, herbicides, gasoline, chlorine, paint thinner, radiator fluid, or battery acid.
  • Electrical burns are injuries to tissue due to electrical currents caused by household electricity (electrical outlets, uninsulated wires, electrical malfunctions or improper electrical wiring), lightning, and power lines. Electric burns can also occur when an electric current in water enters the body (ex., poorly maintained wiring for a boat launch).
  • Cold burns, commonly called “frostbite,” occur when tissue damage is due to prolonged cold temperatures. “Frostbite is an injury caused by freezing of the skin and underlying tissues”- Mayo Clinic. It is caused by prolonged exposure to freezing temperatures without adequate clothing/insulation. Cold burns can also be caused by dry ice.

Burn Treatment:

  • Self-treat (DO):
    • Call 911 in the event of an electrical burn, and turn the power off safely, if possible; listen to and follow medical instructions from the 911 operator
    • Prevent further sunburns by staying out of the sun/tanning bed
    • Remove dry chemicals/try to remove as much of the chemical from the skin as possible safely (use appropriate gloves)
    • Run a chemical burn under cool water
    • Remove contaminated clothes and jewelry, and remove tight clothing/jewelry/etc. from around the burn prior to swelling
    • If a cold burn, rewarm slowly by soaking the skin in warm water for ~30 minutes and remove wet clothing (make sure to remove any rings/jewelry before rewarming)
    • Cool minor burns to the skin due to sun, fire, steam, and hot liquids using a cool, clean towel or cool water
    • Moisturize skin with non-irritating lotion or aloe lotion/gel
    • Hydrate by drinking water to prevent dehydration
    • Use over-the-counter pain relievers such as ibuprofen or acetaminophen if needed (use as directed on the label)
    • Cover the burn with a sterile bandage to keep it clean (ex., gauze) and to protect the skin from infection
  • Self-treat (DON’T):
    • Don’t get more exposure from the source of the burn
    • Don’t add additional chemicals to burn to treat the area without medical advice
    • Don’t touch a person still in contact with an electrical source
    • Don’t use grease/lard (these are nonsterile)
    • Don’t use Vaseline initially (first need to cool and clean burn)
    • Don’t walk on frostbitten feet, and do not submerge in hot water (instead, use warm water to rewarm the area slowly)
    • Don’t break blisters
    • Don’t scratch the burn
    • Don’t use ice
  • Complications:
    • Dehydration
    • Infection
    • Scarring
    • Pain
    • Breathing problems from inhalation of smoke
    • Internal injuries
    • Cardiac arrhythmias
    • Severe burns
    • Gangrene
    • Low body temperature (hypothermia)
    • Loss of sensation/numbness in the frostbitten area
    • Skin aging: repetitive sun exposure and/or severe burns can make the skin age faster
    • Precancerous lesions/cancerous lesions: sun exposure and sunburns can damage the skin enough to cause precancerous lesions, which can then develop into cancerous lesions
  • Prevention:
    • Proper clothing, gloves, shoes, googles and other attire for the activity and weather
    • Use sunscreen daily (SPF 30), even on cloudy days, winter, etc.
    • Don’t suntan and try to stay out of the sun during peak UV hours (ex., 10 am -4 pm)
    • Don’t use tanning beds
    • Get yearly skin checks by a medical professional to identify precancerous lesions (for prevention of skin cancer)
    • Keep children away from stoves, ovens, grills, fireplaces, fireplaces/firepits, propane torch, candles, hot equipment or engines
    • Never leave pots/pans on the stove unattended
      • Do not leave pots/pans that are on the stove which can be easily reached by children
    • Pay careful attention when near burn sources such as fire and maintain a safe distance
    • Check the hot water heater’s thermostat to prevent burns
    • Keep chemicals out of reach of children and properly stored
    • Install and check the function of smoke detectors and fire extinguishers in the home
    • Wear appropriate protective clothing for the specific chemical when using chemicals, such as long pants and shirt, gloves, goggles, and a mask
    • Be aware of any chemicals getting on the skin and exposure
    • Use a certified electrician for house wiring and get help if any outlets or wires seem to be malfunctioning
    • Do not drive over power lines or approach downed lines, and call 911 if you observe damaged power lines
    • Check water bodies for electrical current (for example, around docks)
    • Try to limit time outside to less than15 minutes before going inside to rewarm
    • Don’t spend too much time out in the cold; know how long you will be outside/the temperature/and how to get back to a warm place safely
  • When to seek professional medical help:
    • Call 911 in the event of an electrical burn, and turn the power off safely, if possible; listen to and follow medical instructions from the 911 operator
    • Any injury due to electricity
    • Large burns or blisters, blisters on the face, hands, major joint, or genitals
    • Deep and/or severe burns
    • Signs of infection (redness around injury, pus, fever, chills, swelling, pain, etc.)
    • Severe pain after rewarming from a cold burn
    • Symptoms of hypothermia (confusion, drowsiness, pale and cold skin, weakness, shivering, etc.
    • If you experience difficulty breathing, severe swelling, burns not getting better, worsening pain, headache, confusion, nausea, fever, or chills
    • If you feel you are having any severe symptoms or would feel more comfortable being seen by a healthcare provider
    • Keep a healthcare professional’s contact information available on your phone, provide healthcare professionals with as much information as possible, and keep a list of medications currently taking (prescribed and over the counter) with you or on your phone
    • Note: burns may require a tetanus shot and/or need medicine (such as antibiotics) to fight infection (if you don’t know if you have had your childhood scheduled tetanus shots, got your last tetanus shot less than10 years ago, or have had less than 3-lifetime doses of tetanus shot see a medical provider)
Sunburn.

Sunburn.
Photo credit: @Lost_in_the_Midwest-stock.adobe.com

Blood

There are various types of injuries that can result in bleeding when spending time outdoors.

Puncture wound/scrape on patient's leg.

Puncture wound/scrape on patient’s leg.
Photo credit: @sima-stock.adobe.com

Cuts, scrapes, punctures, and lacerations are breaks in the skin that can be superficial or deep. A puncture, for example, from a nail, is an injury to deep tissue layers, or a laceration is skin and underlying tissues that are cut or torn.

Cut, Scrap, Puncture, Laceration Treatment:

  • Self-treat (DO)
    • Call 911 or go to the Emergency Department for bleeding that does not stop with direct pressure or if you are losing a significant amount of blood
      • Unable to stop the bleeding (ex., injury is still bleeding after 10-15 minutes) or severe bleeding (ex., bleeding that makes you dizzy or your blood pressure drop)
    • Call 911 or go to the Emergency Department for bleeding that causes shock (confusion/decreased alertness, clammy skin, dizziness/light-headedness, low blood pressure, rapid pulse, shortness of breath, etc.)
    • Wash your hands and clean the area with warm soap and water
    • Bandage the area to keep clean and stop the bleeding (can hold pressure with sterile gauze to stop the bleeding)
  • Self-treat (DON’T)
    • Don’t attempt to remove objects (ex., nails, glass) and instead have a medical professional remove the object
    • Don’t use a tourniquet unless you are trained to use one
  • Complications
    • Pain
    • Infection
    • Bleeding
  • Prevention
    • Wear gardening gloves to avoid cuts and scrapes while gardening
    • Use proper cutting technique when using tools
    • Use caution with sharp objects, including glass, nails, and tools
    • Wear closed-toe, hard-sole shoes while outside to prevent a nail, blade, tool, or other sharp object from causing an injury
  • When to seek professional medical help:
    • Call 911 or go to the Emergency Department for bleeding that does not stop with direct pressure or if you are losing a significant amount of blood
      • Unable to stop the bleeding (ex., injury is still bleeding after 10-15 minutes) or severe bleeding (ex., bleeding that makes you dizzy or your blood pressure drop)
    • Call 911 or go to the Emergency Department for bleeding that causes shock (confusion/decreased alertness, clammy skin, dizziness/light-headedness, low blood pressure, rapid pulse, shortness of breath, etc.)
    • If an object is lodged in the skin (ex., nails, glass), have a medical professional remove the object
    • Signs of infection (redness around injury, pus, fever, chills, swelling, pain, etc.)
    • Keep a healthcare professional’s contact information available on your phone, provide healthcare professionals with as much information as possible, and keep a list of medications currently taking (prescribed and over the counter) with you or on your phone
    • Note: some injuries may require a tetanus shot and/or need medicine (such as antibiotics) to fight infection (if you don’t know if you have had your childhood scheduled tetanus shots, got your last tetanus shot less than10 years ago, or have had less than 3-lifetime doses of tetanus shot see a medical provider)

Bruises

Bruises are a focal area of skin discoloration that can occur when blood vessels underlying the skin are broken. Bruises commonly occur due to trauma to damage to the skin and deeper structures. Most bruises will typically resolve without treatment. The color of bruises can change based on the extent of injury and may change during healing. Most bruises typically begin with a bluish or purplish hue, later transitioning to a green or yellow color prior to complete healing. This process may take weeks to months.

Bruise Treatment:

  • Self-treat (DO)
    • Call 911 if you develop severe/intense pain, feel extreme pressure and have significant swelling, along with a tingling/burning sensation in the skin and muscle tightness
    • Use an ice pack, which may aid in reducing swelling
      • Wrap ice in a washcloth/paper towel; don’t leave it on for more than 10 minutes
      • Can also use a sealed bag of frozen fruit or peas
    • Elevation of the impacted area to encourage blood flow
    • Rest
    • Use pain relievers such as NSAIDS or Tylenol to reduce symptoms if needed
  • Self-treat (DON’T)
    • Don’t massage the bruise
      • It can break blood vessels and cause more damage
    • Don’t put ice directly on the bruise; it can harm the skin more
    • Don’t put raw meat on bruises; it can contain loads of harmful bacteria and lead to severe infections
    • Don’t wrap or bandage the area too tight
    • Don’t ignore constant bruising or bruising with minor trauma. See a healthcare provider to evaluate any underlying causes
  • Complications
    • Uncomfortable and quite painful, especially to touch
    • Compartment syndrome (pressure builds up within the muscle and can decrease blood flow, causing significant damage)
      • Bleeding into muscle compartments can cause stretching/pressure of vessels and nerves, which can lead to muscle damage and death
  • Prevention
    • Engaging in safety measures while working with machinery or heavy tools can help prevent injury
    • Wear proper sports equipment such as helmets, shin guards, and hip guards can help avoid injuries
    • Elderly individuals and those on blood thinners are more susceptible to bruises due to skin fragility and decreased blood viscosity. These individuals should take extra precautions when engaging in physical activity or any physically demanding work
  • When to seek professional medical help:
    • Call 911 if you develop severe/intense pain, feel extreme pressure and have significant swelling, along with a tingling/burning sensation in the skin and muscle tightness
    • Bruising without injury or due to light contact or constant bruising may be a sign of an underlying blood disorder
    • Keep a healthcare professional’s contact information available on your phone, provide healthcare professionals with as much information as possible, and keep a list of medications currently taking (prescribed and over the counter) with you or on your phone
Bruise.

Bruise.
Photo credit: @spyrakot-stock.adobe.com

Summary

Whether you are outdoors for work or play, there are numerous benefits. You may be outside as a necessity for a job or to complete a task, or outside for a hobby, exercise, recreation, spectator, mental wellness, stress relief, or simply to get some vitamin D. However, as mentioned above, there are risks and sometimes an injury resulting from a bite or burn, or an injury creating a bloody situation is inevitable; so be prepared. Keep a healthcare professional’s contact information available on your phone. Provide healthcare professionals with as much information as possible, and keep a list of medications currently taking (prescribed and over the counter) with you or on your phone. Have a first aid kit available.

First Aid Kit.

First Aid Kit.
Photo credit: @showcake-stock.adobe.com

Per the Center for Disease Control website, the American Red Cross suggests that a first-aid kit for a family of four include the following items:

  • A first-aid guide
  • 2 absorbent compress dressings (5 x 9 inches)
  • 25 adhesive bandages (assorted sizes)
  • 1 adhesive cloth tape (10 yards x 1 inch)
  • 5 antibiotic ointment packets
  • 5 antiseptic wipe packets
  • 2 packets of aspirin (81 mg each)
  • 1 emergency blanket
  • 1 breathing barrier (with one-way valve)
  • 1 instant cold compress
  • 2 pair of nonlatex gloves (size: large)
  • 2 hydrocortisone ointment packets
  • 1 3-inch gauze roll (roller) bandage
  • 1 roller bandage (4 inches wide)
  • 5 3 x 3-inch sterile gauze pads
  • 5 sterile gauze pads (4 x 4 inches)
  • A thermometer (non-mercury/non-glass)
  • 2 triangular bandages
  • Tweezers
  • Specific needs and medications (EpiPen and insulin)

CALL 911 and/or go to ER for the following:

  • Call 911 if there is severe bleeding from a bite
  • Call 911 for snake bites from a venomous snake and bites from sharks & alligators
    • If possible, describe the snake to the healthcare professionals
    • If possible, take a picture from a safe distance
  • Call 911 if an insect or jellyfish sting causes chest pain, nausea, severe diarrhea/vomiting, severe sweating, loss of breath, serious swelling, slurred speech (CDC, Mayo Clinic), or any severe allergic reaction
    • If the individual stung has a known allergy to insects, use the individual’s prescribed EpiPen
  • Call 911 and/or go to the Emergency Room if you develop symptoms of anaphylaxis, including throat and mouth swelling, hives, and difficulty breathing (This is a potentially fatal complication that requires immediate management with an EpiPen)
  • Call 911 in the event of an electrical burn, and turn the power off safely, if possible; listen to and follow medical instructions from the 911 operator
  • Call 911 or go to the Emergency Department for bleeding that does not stop with direct pressure or if you are losing a significant amount of blood
    • Unable to stop the bleeding (ex., injury is still bleeding after 10-15 minutes) or severe bleeding (ex., bleeding that makes you dizzy or your blood pressure drop)
  • Call 911 or go to the Emergency Department for bleeding that causes shock (confusion/decreased alertness, clammy skin, dizziness/light-headedness, low blood pressure, rapid pulse, shortness of breath, etc.)
  • Call 911 if you develop severe/intense pain, feel extreme pressure and have significant swelling, along with a tingling/burning sensation in the skin and muscle tightness

Follow up with a medical provider for the following:

  • When symptoms include a high fever, severe headache and body aches from a bite
  • A rash resulting from an infection
  • A rash with a new onset fever, headache and/or severe symptoms
  • A rash with the formation of new blisters or open sores, draining pus, worsening pain and redness, or spread of the rash beyond original boundaries to new areas
  • If you observe a bull’s eye rash or a rash on the hands and feet, specifically impacting the palms and soles, from a tick bite
  • Any injury due to electricity
  • Large burns or blisters, blisters on the face, hands, major joint, or genitals
  • Deep and/or severe burns
  • Severe pain after rewarming from a cold burn
  • Symptoms of hypothermia (confusion, drowsiness, pale and cold skin, weakness, shivering, etc.
  • If after a burn you experience difficulty breathing, severe swelling, burns not getting better, worsening pain, headache, confusion, nausea, fever, or chills
  • If an object is lodged in the skin (ex., nails, glass), have a medical professional remove the object
  • Signs of infection (redness around injury, pus, fever, chills, swelling, pain, etc.)
  • Bruising without injury or due to light contact or constant bruising may be a sign of an underlying blood disorder
  • If you feel you are having any severe symptoms or would feel more comfortable being seen by a healthcare provider
  • Note: some bites, burns, and injuries may require a tetanus and/or rabies shot and/or need medicine (such as antibiotics) to fight infection (if you don’t know if you have had your childhood scheduled tetanus shots, got your last tetanus shot less than10 years ago, or have had less than 3 lifetime doses of tetanus shot see a medical provider)

References:

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  4. https://my.clevelandclinic.org/health/diseases/17413-rashes-red-skin
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  8. https://www.mayoclinic.org/diseases-conditions/frostbite/symptoms-causes/syc-20372656#:~:text=Frostbite%20is%20an%20injury%20caused,become%20hard%20or%20waxy%2Dlooking.
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  13. Cameron P, O’Reilly G. Trauma overview. In: Cameron P, Little M, Mitra B, Deasy C, eds. Textbook of Adult Emergency Medicine. 5th ed. Philadelphia, PA: Elsevier; 2020:chap 3.1.
  14. Schafer AI. Approach to the patient with bleeding or thrombosis. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 157.
  15. https://medlineplus.gov/ency/article/007213.htm#:~:text=A%20bruise%20is%20an%20area,soft%20tissue%20beneath%20the%20skin.
  16. https://my.clevelandclinic.org/health/diseases/15439-frostbite
  17. https://my.clevelandclinic.org/health/drugs/24283-tetanus-shot
  18. https://www.webmd.com/first-aid/helping-bruise-heal
  19. https://myfwc.com/research/saltwater/sharks-rays/interaction/reducing-odds/
  20. https://blogs.cdc.gov/publichealthmatters/2021/05/first-aid-kits/
  21. www.cdc.gov
  22. www.mayoclinic.org
  23. www.abcpediatricclinic.com

Reviewer(s):
T. Robert Dyar, M.D.
Melissa Bales, Rural Health and Nutrition Associate, Clemson Extension
Mary Beth Johnstone, Rural Health and Nutrition Associate, Clemson Extension
Rhonda Matthews, Rural Health and Nutrition Program Team Director, Clemson Extension
Danielle McFall, Rural Health and Nutrition Associate, Clemson Extension

Originally published 12/24

If this document didn’t answer your questions, please contact HGIC at hgic@clemson.edu or 1-888-656-9988.

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