Eva

Spiders

Dealing with venomous spiders

Australia has both venomous and non-venomous species of spiders to humans. As with snakes, treat all spider bites as venomous unless proven otherwise.

Identification Spiders in the Greater Sydney Region

DEADLY AND DANGEROUS

Funnel webs have extremely venomous bites. They are among the most deadly spiders in the world, however, fatalities are extremely low since the development of effective and readily available antivenoms.

Mouse spiders are also up there. According to the Australian Museum: “Some mouse spiders have a very toxic venom which is potentially as dangerous as that of the Sydney Funnel-web Spider… Because of their potential toxicity to humans, first aid treatment should be provided as recommended for funnel-web spider envenomation. Fortunately, funnel-web spider antivenom has proven effective in cases of mouse spider bite”.

Redbacks are common across Australian and readily found in urban areas. Although only the female bite is dangerous to humans, more than 250 antivenoms are administered a year over the summer months.

Funnel web spiders (Atracinae)

Male funnel web spider. Photo credit: Sputniktilt  via commons.wikimedia.org / CC BY-SA 3.0

Male funnel web spider. Photo credit: Sputniktilt via commons.wikimedia.org / CC BY-SA 3.0


Female funnel web spider. Photo credit: Sputniktilt  via commons.wikimedia.org / CC BY-SA 3.0

Female funnel web spider. Photo credit: Sputniktilt via commons.wikimedia.org / CC BY-SA 3.0

Mouse spiders (Missulena)

Male mouse spider. Photo credit: Friends of Chiltern Mt Pilot National Park via Foter.com / CC BY-NC-SA

Male mouse spider. Photo credit: Friends of Chiltern Mt Pilot National Park via Foter.com / CC BY-NC-SA


Female mouse spider. Photo credit: ron_n_beths pics via Foter.com / CC BY-NC

Female mouse spider. Photo credit: ron_n_beths pics via Foter.com / CC BY-NC

Redback spider (Latrodectus hasselti)

Redback spider. Photo credit: Bill & Mark Bell via Foter.com / CC BY-NC-SA

Redback spider. Photo credit: Bill & Mark Bell via Foter.com / CC BY-NC-SA

VENOMOUS – PAINFUL BITE

Black house spider (Badumna insignis)

Black House spider. Photo credit: Bill & Mark Bell via Foter.com / CC BY-NC-SA

Black House spider. Photo credit: Bill & Mark Bell via Foter.com / CC BY-NC-SA

LOW RISK SPIDERS

Wolf spiders (Lycosidae)
Wolf spiders rarely bite, especially if left unhandled. They are common around houses, but low risk to humans.

Wolf spider. Photo credit: Tone Killick via Foter.com / CC BY-NC-SA

Wolf spider. Photo credit: Tone Killick via Foter.com / CC BY-NC-SA

Trap door spiders (Ctenizidae)

Trap door spider. Photo credit: GregGilbert1 via Foter.com / CC BY

Trap door spider. Photo credit: GregGilbert1 via Foter.com / CC BY

Garden orb weaving spider (Eriophora transmarina)

Garden orb weaving spider. Photo credit: Misenus1 via Foter.com / CC BY-NC-SA

Garden orb weaving spider. Photo credit: Misenus1 via Foter.com / CC BY-NC-SA

St Andrew’s Cross spiders (Argiope)

St Andrew's Cross female spider. Photo credit: James Niland via Foter.com / CC BY

St Andrew’s Cross female spider. Photo credit: James Niland via Foter.com / CC BY

Golden orb weaver (Nephila)

Photo credit: BRJ INC. via Foter.com / CC BY-NC-ND

Photo credit: BRJ INC. via Foter.com / CC BY-NC-ND

Huntsman spiders (Sparassidae)

Huntsman spider. Photo credit: eliotc via Foter.com / CC BY-NC

Huntsman spider. Photo credit: eliotc via Foter.com / CC BY-NC

White-tail spiders (Lampona)
A common misconception is that white tailed spiders have a deadly bite and cause skin necrosis. Yet, their venom is non-lethal. In some cases, bacterial infection is the biggest source of danger to people that have been bitten.

White tail spider. Photo credit: No Middle Name via Foter.com / CC BY-NC-SA

White tail spider. Photo credit: No Middle Name via Foter.com / CC BY-NC-SA

Prevention Preventing spider bites

The NSW government has this advice for avoiding funnel web and redback spider bites:

  • Keep your garden free of rubble and rubbish where spiders can hide.
  • Wear shoes, gloves and long sleeved shirt when working in the garden.
  • Check shoes and households items for spiders.

For bushwalkers, we recommend:

  • Take care if moving rocks or logs.
  • Wear shoes around campsite, especially at dusk and dawn when it’s harder to see.
  • Check shoes and anything else left out for spiders and insects before use.

Signs and Symptoms Signs and symptoms of spider bites

In general, we split Australian spiders into three medically relevant groups and treat accordingly: big black spiders (funnel webs, mouse spiders), redback spiders and all other spiders.

General signs and symptoms of spider bites include:

  • Sharp pain at bite site
  • Profuse sweating
  • Nausea, vomiting and abdominal pain.

Additional signs and symptoms of a Funnel web spider bite:

  • Copious secretion of saliva
  • Muscular twitching and breathing difficulty
  • Small hairs stand on end
  • Numbness around mouth
  • Copious tears
  • Disorientation
  • Fast pulse
  • Markedly increased blood pressure
  • Confusion leading to unconsciousness.

Additional signs and symptoms of a red-back spider bite:

  • Intense local pain which increases and spreads
  • Small hairs stand on end
  • Patchy sweating
  • Headache
  • Muscle weakness or spasms.

Possible signs and symptoms of other spider bites:

  • Burning sensation
  • Swelling
  • Blistering.

Management Management of spider bites

St John Ambulance makes the following management recommendations:

  1. Follow DRSABCD .
  2. Lie the patient down.
  3. Calm and reassure the patient.
  4. Apply management for:
  • Funnel-web / Mouse spider
    • If on a limb, apply a broad crepe bandage over the bite site as soon as possible.
    • Apply a heavy crepe or elasticised roller bandage starting just above the fingers or toes of the bitten limb, and move upwards on the limb as far as can be reached (include the bite). Apply firmly without stopping blood supply to the limb.
    • Immobilise the injured limb with splints and ensure the patient does not move.
    • Ensure an ambulance (000) has been called or emergency beacon activated.
  • Red-back spider
    • Apply an icepack (cold compress) to the bitten area to lessen pain.
    • Seek medical attention if patient develops severe symptoms.
  • Other spider bites
    • Wash with soap and water .
    • Apply ice pack (cold compress) to relieve the pain.
    • Seek medical attention if patient develops severe symptoms.

Special thanks to Fran Van Den Berg for reviewing and contributing to this article:
FRAN VAN DEN BERG

Citizen Science Officer
National Parks Association of NSW

Ticks

Dealing with tick bites

Ticks are parasites that live off blood of humans and animals. Ticks get to blood by attaching themselves to the skin of their host with sharp mouthparts, piercing the skin and injecting saliva into the area to prevent blood clotting. In the case of the paralysis tick, it’s the transfer of the highly toxic saliva from that can have serious medical implications for the host.

Special thanks to Henry Lydecker for reviewing and contributing to this article:
HENRY LYDECKER | PhD Candidate
School of Life and Environmental Sciences | Faculty of Science
THE UNIVERSITY OF SYDNEY

Identification Identification of ticks in NSW

In Eastern Australia, 95% of tick bites are due to the Paralysis Tick (Ixodes holocyclus), and most tick-borne illnesses are the result of a Paralysis Tick bite.

Photo credit: Ryan Wick via Foter.com / CC BY

Photo credit: Ryan Wick via Foter.com / CC BY

This species may also be referred to as the grass tick, seed tick and bush tick depending upon the development stage: the egg, larvae (around 1mm and light brown in colour when not full of blood), nymph (around 2mm and pale brown) and the adults (4–5mm in length, without blood).

Tick life cycle (S.L. Doggett, Department of Medical Entomology, Westmead Hospital) as described above

Tick life cycle (S.L. Doggett, Department of Medical Entomology, Westmead Hospital) as described above

Prevention Preventing tick bites

Ticks are usually more likely to be found in more humid, less windy, more dense vegetation, more leaf litter, so avoiding these areas can be a way of dodging tick bites.

Unfortunately, bushwalks generally go through these habitats! Long sleeved shirts and pants are key for reducing the likelihood of tick bites, as well as insect repellent containing DEET or Picardin.

In addition the NSW governemnt website suggests:

  • Tuck long pants into socks and long sleeved shirts in pants.
  • Use light coloured clothing so that ticks are easier to spot.
  • Check yourself regularly for ticks. Tick prone areas include back of the head and neck, groin, armpits and back of knees. Get a friend to check areas like your back that are hard to inspect, or use a mirror.
  • After you get home from a trip, put all clothing in a hot dryer for at least 10 minutes to kill any remaining ticks.

Signs & Symptoms Signs & symptoms of ticks

Although tick bites are not uncommon in Australia, there has been very little medical research into tick-borne illnesses or best practice in tick removal to date. Here’s the best of our knowledge so far!

For most people, tick bites cause local swelling, redness and itchiness at the bite site, but generally pose no medical problems as long as the tick is removed quickly.

On rare occasions, people development allergic reactions (and even anaphylaxis) to ticks. While rare, allergic reactions can be serious, so consult your doctor if you have a history of allergic reactions with tick bites, or if you are concerned about possible allergic reactions.

There are two main tick-borne diseases that can occur in Australia, Queensland Tick Typhus and Flinders Island Spotted Fever. Very occasionally, ticks bites may lead to tick paralysis.

Queensland Tick Typhus
Queensland Tick Typhus is is a condition caused by a bacterium Rickettsia australis, and is transmitted by the Tick species Ixodes holocyclus and Ixodes tasmani. A blood test is the clinic confirmation of the condition, and is treated with antibiotics (although fatalities have occurred rarely).

Symptoms include:

  • Rashes
  • Eschars
  • Headaches
  • Fever
  • Flu-like symptoms
  • Lymph node tenderness

Flinders Island Spotted Fever
Flinders Island Spotted Fever a condition associated with the bacterium Rickettsia honei, and is also transmitted by ticks.

Symptoms include [note]Stewart RS Flinders Island spotted fever: a newly recognised endemic focus of tick typhus in Bass Strait, part 1: clinical and epidemiological features. Med J Aust 1991;154:94–9; Graves SR, Dwyer BW, McColl D, McDade JE Flinders Island spotted fever: a newly recognised endemic focus of tick typhus in Bass Strait, part 2: serological investigations. Med J Aust 1991;154:99–104[/note]:

  • Fever
  • Headache
  • Myalgia
  • Transient arthralgia
  • Maculopapular rash
  • Cough (in some cases)

Tick paralysis
Very occasionally, ticks bites may lead to tick paralysis, an extremely rare, but severe conditions. In the few known cases, tick paralysis has been have recorded in the very young, very old, or otherwise immunologically impaired.

Early signs and symptoms of tick paralysis to include:

  • Rashes
  • Headache
  • Fever
  • Influenza like symptoms
  • Tenderness of lymph nodes
  • Unsteady gait
  • Intolerance to bright light
  • Increased weakness of the limbs
  • Partial facial paralysis

PET OWNERS BE CAREFUL: Tick paralysis is serious (often fatal) in dogs. Owners walking their dogs near the bush need to check pets carefully afterwards for ticks.

Lymes disease
Lymes disease is a seroius tick-borne disease that if left untreated, the infection can spread through the bloodstream to the brain and heart.

Several species of ticks in Africa, Asia, Europe, and North America are known to carry and transmit species of Borrelia bacteria that are known to cause Lyme disease in humans.

Australian ticks like the Paralysis tick have been suspected as possible vectors of Lyme disease, but multiple studies have failed to find any Borrelia species bacteria in these ticks. The only known species in the Borrelia genus that occurs in Australia is only found in one species of Australian tick that is only known to bite Echidnas [note]Loh, Siew-May, et al. “Novel Borrelia species detected in echidna ticks, Bothriocroton concolor, in Australia.” Parasites & Vectors 9.1 (2016): 339[/note]. This species of bacteria is not in the same group as those known to cause Lyme disease, so it is unlikely to be a health threat.

There are, however, advocacy groups in Australia (Primarily the Lymes Disease Association of Australia) that acknowledge Lymes Disease (or Lyme-like diseases) to occur in Australia, and advocate for Lymes Disease to diagnosed and treated accordingly.

Many health workers and public health researchers believe that Queensland Tick Typhus and Flinders Island Spotted Fever are the most common tick-related health issues in Australia. It is widely suspected that patients who believe they have Lyme’s disease actually have a subclinical infection of tick typhus (although there is currently no research to support this).

Regardless of the label, tick-borne diseases can be serious. Consult your health professional immediately if you have any concerns following a tick bite.

Tick-induced meat-allergies
A peculiar meat-allergy has also emerged in recent years, affecting people found in coastal Eastern Australia. The tick-induced mammalian meat allergy (MMA) has seen some people bitten by paralysis ticks to develop a severe allergic reaction to meat products and sometimes dairy and gelatine. If you believe you have developed red meat allergy, consult your doctor for referral to a specialist.

TRAVELLING ABROAD?
If you travel abroad, consult local guides for information about ticks and tick-borne diseases that are relevant there. If you fall sick upon returning to Australia, make sure to discuss your travel with your doctor.

Management Management of ticks

The NSW government health website suggests the following for tick removal:

“Ticks should be removed as soon as possible using fine tipped forceps or fine surgical scissors. Hold the tick as close as possible to the surface of the skin and pull with steady pressure. Avoid squeezing the body of the tick during removal. If you are unable to do this, see your doctor to remove the tick. Do not use methylated spirits, nail polish remover, alcohol, petroleum jelly or any other products on ticks prior to removal as it will cause the tick to inject more toxins.
Note: In individuals with a history of allergic reactions to tick bites, ticks should be removed as soon as possible, but only by a doctor and where resuscitation facilities are readily available”.

Photo credit: https://www.cdc.gov/ticks/removing_a_tick.html

Photo credit: https://www.cdc.gov/ticks/removing_a_tick.html

After removal, apply antiseptic cream to the bite area. If tick removal is difficult, or you begin to suffer rash, swelling, signs of infection, muscle weakness in the bite site area or flu like symptoms, seek medical attention urgently.

DO NOT:

  • Do anything to irritate the tick because this makes it harder to completely remove it (e.g. squeezing, rubbing, scratching).
  • Grasp the tick by the body.
  • Apply methylated spirits, kerosene or fingernail polish.
  • Use a lighted match, or cigarette.

NOTE

The Australasian Society of Clinical Immunology and Allergy recommends killing ticks by freezing them off using ether-containing sprays (e.g. Wart-Off Freeze®, Elastoplast Cold Spray®). This method is still in the research and development phase, and while promising, is not currently recommended by the NSW government health website.

A recent literature review published in early 2017 concludes [note]Coleman N and Coleman S. Methods of tick removal: A systematic review of the literature. AMJ 2017;10(1):53–62[/note]:
“The best method is to remove the tick as soon as possible after it is detected, using either fine-tipped tweezers or a reputable commercially produced tick removal tool to pull the tick away from the site of attachment……Other methods of removal, such as freezing, while promising, have not yet been scientifically validated.”

So the conclusion is: stick to tweezers, until other methods are validated.

Other Creepy Crawlies

Dealing with other types of creepy crawlies

Here we run through all the other common creepy crawlies found in NSW that bite and sting (information based on articles from the Australian museum).

Identification Identification of other creepy crawlies

Bed Bugs (Cimicidae)
Bedbugs are blood feeders and most active at night. Reactions vary from none to severe irritation and localised swelling.

Photo credit: Armed Forces Pest Management Board via Foter.com / CC BY-NC-ND

Photo credit: Armed Forces Pest Management Board via Foter.com / CC BY-NC-ND

Honey bees (Apis mellifera)
Bees sting as a last resort defence mechanism killing themselves in the process as they drive a barbed stinger into flesh. Bee stings generally cause local pain and swelling, but can cause severe allergic reactions in some cases.

Photo credit: Dendroica cerulea via Foter.com / CC BY-NC-SA

Photo credit: Dendroica cerulea via Foter.com / CC BY-NC-SA

European wasps (Vespula germanica)
Unlike bees, wasps do not die upon stinging. Stings generally cause local pain and swelling, but can cause severe allergic reactions in some cases.

Photo credit: epitree via Foter.com / CC BY-NC

Photo credit: epitree via Foter.com / CC BY-NC

Biting and non-biting flies
Within Australia, horse flies or March flies (Family Tabanidae) are the most significant biting flies. House flies (Musca domestica) can also cause problems by carrying millions of bacteria in its gut, mouthparts or feet.

Photo credit: Jacko 999 via Foter.com / CC BY-NC-SA

Photo credit: Jacko 999 via Foter.com / CC BY-NC-SA

Mosquitoes (Culicidae)
Mosquitoes are blood suckers that carry diseases such as malaria and transfer the disease to humans via salivary glands. Malaria is not a major health problem In Australia, but other mosquito-borne diseases are increasing (e.g. Ross River Virus, Dengue and Murray Valley Encephalitis).

Photo credit: Ecuador Megadiverso via Foter.com / CC BY-NC-SA

Photo credit: Ecuador Megadiverso via Foter.com / CC BY-NC-SA

Ants
Myrmecia (the bull ants and jack-jumpers) and Odontomachus ants are aggressive animals with the potential to inflict painful stings. Ants can pose threats to people with allergic reactions.

Photo credit: david_a_l via Foter.com / CC BY-NC-ND

Photo credit: david_a_l via Foter.com / CC BY-NC-ND

Scorpion
Found under logs, rocks and in shallow burrows in earth banks. Can inflict painful sting.

Photo credit: antisense via Foter.com / CC BY-NC-SA

Photo credit: antisense via Foter.com / CC BY-NC-SA

Centipede
Found under logs, rocks and in shallow burrows in earth banks. Can inflict painful sting.

Photo credit: Black_Claw via Foter.com / CC BY

Photo credit: Black_Claw via Foter.com / CC BY

Caterpillar
Australian Lepidoptera (moths and butterflies) have caterpillars with stinging hairs and/or fragile spines which can cause painful stings to people that accidentally touch them.

Photo credit: dhobern via Foter.com / CC BY

Photo credit: dhobern via Foter.com / CC BY

Prevention Preventing other creepy crawly bites and stings

In general, with all creepy crawly bites, wearing insect repellent, long sleeved clothing and checking shoes before putting them on are good ways to minimise the risk of being bitten.

Signs and symptoms Signs and symptoms of other creepy crawly bites and stings

The NSW Health Direct website lists 6 common signs and symptoms of creepy crawly stings:

  1. An intense burning feeling.
  2. Redness around the sting site.
  3. Pain which generally eases after an hour or so.
  4. Swelling around the sting.
  5. In cases of allergic reaction, swelling may be more severe and affect a larger part of the body, for example the whole leg or arm may become swollen.
  6. Allergic reactions may cause further swelling, pain and in some cases blisters will form.

By comparison, a creepy crawly bite that only leaves a puncture mark on the skin, generally has the following signs and symptoms:

  • Skin irritation;
  • Inflammation or swelling;
  • A bump or blister around the bite mark.

Skin rashes, itching, stinging sensations, and/or swelling are all common. On rare occasions, patients go into Anaphylactic shock.

Management Management of other creepy crawly bites and stings

Itching is a common outcome of creepy crawly stings, but scratching the itch can cause more damage by breaking the skin and opening a wound to infection.

The Australian governement health website recommends the following steps to relieve itching:

  • Try not to scratch the area – keep your nails short to prevent breaking the skin if you do scratch.
  • A cool bath or shower may help to soothe the itching – gently pat yourself dry with a clean towel, but do not rub or use the towel to scratch yourself.
  • Avoid perfumed skin care products.
  • Try to wear loose cotton clothing, which can help prevent you overheating and making the itch worse – avoid fabrics which irritate your skin, like wool or scratchy fabrics.
  • An ice pack may relieve the itching but should not be placed directly against the skin – you can make an ice pack by using a bag of frozen peas wrapped in a clean cloth.
  • There are medicines available to ease the symptoms of itching – speak to a pharmacist for further advice and to make sure any medicines you take are suitable for you.
  • If you are in pain, get advice on medicines from a pharmacist, or from a doctor on medicines you can take.

Bee stings
The Australian governement health website recommends the following steps if you are stung by a bee:

  • Do not use tweezers to remove the sting; bees leave behind a sac of venom, and if you try to use tweezers you will release more venom from the sac.
  • If the stinger is still in the skin, gently try to remove it by scraping it carefully from the side with the edge of a firm object, such as a fingernail or credit card.
  • When you have removed the sting, wash the affected area with soap and water and dry the area gently.
  • If the pain is persistent and continues, massage the area around the sting or bite for 10 minutes using an ice-pack. This will only provide temporary pain relief.

Mosquito bites
The Australian government health website recommends to wash the area with soap and water and apply antiseptic. Cold packs may help with local pain and swelling.

Scorpion or centipede
The Australian government health website recommends the following steps if stung by a scorpion or centipede stings:

  • Apply an ice pack to the sting or bite site.
  • Clean the wound with antiseptic or wash with soap and water to help prevent secondary infection.
  • Use a painkiller.

Caterpillar
The Australian government health website recommends to take these steps if stung by a caterpillar:

  • Remove visible caterpillar hairs with tweezers.
  • Apply and remove adhesive tape to the area to remove the finer caterpillar hairs.
  • Do not scratch or rub the area, this may cause the hairs to penetrate deeper into the skin.

Special thanks to Margot Law for reviewing and contributing to this article:
Margot Law

Citizen Science Officer
National Parks Association of NSW

Marine Stings

Dealing with stinging marine species

There are a lot of marine creatures that bite or sting, an evolutionary development to defend and hunt underwater. Some deliver venom via spines, tentacles or teeth, while others aren’t venomous but have sophisticated teeth for attacking prey and defending themselves (e.g. sharks).

The most common marine stings are from jellyfish, mainly bluebottles, followed by spiny fish and stingrays. Box jellyfish are the most dangerous, but only found in the tropics. Likewise blue-ringed octopi and sea snakes pose significant risks, but are attacks are uncommon.

Identification Identification of stinging marine species

We can split marine species into a few groups: animals that are lethal and non-lethal (i.e. those that give a painful bite)

HIGHLY VENOMOUS

  • Box jellyfish (Cubozoa)
    The box jellyfish is the most venomous animal in the world and can cause cardiac arrest within minutes. Box jellyfish are a significant threat, but in the tropics only.
    Photo credit: gautsch. via Foter.com / CC BY-SA

    Photo credit: gautsch. via Foter.com / CC BY-SA

  • Blue-ringed octopus (Hapalochlaena)
    The blue-ringed octopus is a small but deadly creature with enough venom to kill 26 humans. Bites are often painless, resulting in victims not being aware that they’ve been bitten until severe symptoms set in. To make matters worse, there is currently no blue-ringed antivenom, putting it high on the list of deadliest marine creatures.
    However, whilst blue ringed octopus venom is deadly there have only been three deaths in the last century, two in Australia. It’s most important though to avoid turning over rocks in shallow water, especially with bare hands as this is when you can be bitten.
    Photo credit: Angell Williams via Foter.com / CC BY

    Photo credit: Angell Williams via Foter.com / CC BY

  • Sea snakes (Hydrophiinae)
    Although the majority of sea snakes are highly venomous, venom injection is rare and very few human fatalities have been reported. They are another species that is only found in tropical waters. Under these conditions, be wary of sea snakes and manage all bites as though venom has been injected. Nevertheless, be wary of sea snakes and manage all bites as though venom has been injected.
    Photo credit: Daniel, Daniel Kwok via Foter.com / CC BY-NC-ND

    Photo credit: Daniel, Daniel Kwok via Foter.com / CC BY-NC-ND

  • Irukandji jellyfish
    Irukandji are small jellyfish with four long tentacles. Their tentacles can be as small as few centimetres long up to 1 metre. Victims report excruciating pain that is delayed starting for 5-120 minutes, but can last for months. Although often hospitalised, fatalities are rare (3 reported over the last 100 years).
  • News.com.au reports the following experiences from a victim:
    “I cannot begin to explain how excruciating the pain is,” jellyfish toxicologist, Professor Jamie Seymour of James Cook University, told news.com.au.
    “I’ve been stung 11 times and each time I’ve ended up in hospital.
    “It’s very mild to start with, then it takes about 15 to 20 minutes to kick in and it’s overall mind-numbing horrific pain.
    “The last time I got stung across the top of my lip, then I got pins and needles in my feet, pain like red hot pokers in my joints and then overwhelming racking body pain and throwing up for 18 hours.”

    Photo Credit: Marc McCormack, Source:News Corp Australia

    Photo Credit: Marc McCormack, Source:News Corp Australia

    Whilst Irukandji stings are historically rare,there are concerns that the threat is increasing and heading further south from the tropics. It is hard to know as Irukandji stings are often difficult to prove as the animal is so small and symptoms are delayed.

  • Stonefish (Synanceia)
    Stonefish are highly venomous and can be fatal if not treated. Often, stings are the result of accidentally stepping on the fish as it is well camouflaged against rocks and coral. Amazingly, stonefish are able to stay out of water for up to 24 hours, so it’s possible to get stung by an individual washed up on the beach. Stonefish antivenom is the second-most administered in Australia.
    Photo credit: Bill & Mark Bell via Foter.com / CC BY-NC-SA

    Photo credit: Bill & Mark Bell via Foter.com / CC BY-NC-SA

  • Scorpion fish
    Scorpion fish are found in shallow waters around Sydney and are often seen by divers. They have sharp spines coated in a venomous mucus that stings and a puncture to the chest or abdomen may be fatal. Scorpionfish are the most likely animal to cause a painful sting in NSW as they are so common. They are rarely fatal but the sting is debilitating. You are most likely to be stung by putting your hand on one accidentally – so when in the water don’t touch!
    Photo credit: Marine Explorer via Foter.com / CC BY-NC-SA

    Photo credit: Marine Explorer via Foter.com / CC BY-NC-SA

VENOMOUS
Here, we list species that tend to give painful to excruciating bites, but are generally non-leathal. However, be warned, without appropriate medical action, each species still has the potential kill (e.g. patient experiences a severe allergic reaction, breathing difficulties, or has small body frame – children at risk).

  • Blue-bottle (Pacific Man-O-War) jellyfish (Physalia physalis)
    Blue bottles are common throughout marine areas of Australia, and an unwelcome guest for beachgoers. Bluebottle threat is mostly when there is an onshore breeze as this blows the animals on to beach areas. They are between 2-15 cm, and more common on exposed ocean beaches rather than protected waters. A sting, while uncomfortable, is not life-threatening, however, for the very young or elderly there may be medical complications. Avoid the temptation to poke or play with washed up bluebottles as stinging cells in the tentacles may still be active.
    Photo credit: Biusch / CC BY-SA 3.0

    Photo credit: Biusch / CC BY-SA 3.0

  • Jimble jellyfish (Cubozoan)
    Although related to the Box jellyfish, the Jimble jellyfish is nowhere near as potent. It is the only Cubozoan that lives in colder Australian waters, and is occasionally present in high densities in Sydney Harbour.
    Photo credit: https://australianmuseum.net.au/uploads/images/3476/jimble_big.jpg

    Photo credit: https://australianmuseum.net.au/uploads/images/3476/jimble_big.jpg

  • Coneshells
    Brightly coloured coneshells are armed with small harpoons that can sting. Although most stings are no worse than a bee sting, in Australia, there are tropical species that have caused human fatalities. Hence, all species must be treated as potentially dangerous.
    Photo credit: richard ling via Foter.com / CC BY-NC-ND

    Photo credit: richard ling via Foter.com / CC BY-NC-ND

  • Catfish
    Catfish are recognised by their distinctive whiskers around their mouth. They also have sharp, bony spines on the edges of the dorsal and pectoral fins with venom that lock into place when they are threatened. Catfish stings are extremely painful at the site of the sting.

    On the east coast of Australia, the best known species is the eel tailed catfish, which occurs in coastal rivers.

    Photo credit: Sylke Rohrlach via Foter.com / CC BY-SA

    Photo credit: Sylke Rohrlach via Foter.com / CC BY-SA

  • Crown-of-Thorns starfish (Acanthaster planci)
    Crown-of-Thorns has a very wide Indo-Pacific distribution, and is increasingly common around Australia. Crown-of-Thorns lives on corals so it is only found in northern NSW. Since the 1960s there have been population outbreaks where overabundance of the starfish put pressure on the coral species they feed on and coral goes into decline. Overpopulation of the starfish is a concern for vulnerable coral with slow regeneration rates.

    This starfish has spines that can perforate human skin causing sharp pain, persistent bleeding, tissue swelling and nausea. Embedded spines need to be removed surgically.

    Photo credit: Misenus1 via Foter.com / CC BY-NC-SA

    Photo credit: Misenus1 via Foter.com / CC BY-NC-SA

  • Stingray (Myliobatoidei)
    Stingrays have stingers on their tails that can cause pain, swelling, muscle cramps from the venom. Although death is rare, is can happen. Most famously, Steve Irwin was killed in 2006 when the stinger penetrated his thorax.

    The Black Stingray is one of the largest stingrays in Australia, and is found off the coast of Sydney. Although venomous, they are not usually aggressive towards humans. This video beautifully captures how the stingray moves in water: https://www.youtube.com/watch?v=VPfXvWrVK3Y&feature=youtu.be

    Photo credit: Marine Explorer via Foter.com / CC BY-NC-SA

    Photo credit: Marine Explorer via Foter.com / CC BY-NC-SA

  • Stingrays and stingarees are only dangerous if provoked, that is, if you grab them or accidentally tread on them. If walking in shallow water shuffle your feet sideways rather than stepping high – this moves them out of your way if they are around.

  • Sea Urchins
    A relative of starfish, sea urchins are found on coral reefs, rocky shores and beaches. They feed on plant matter growing on ocean surfaces, or burrow to find decaying matter. Black Sea Urchins (Centrostephanus rodgersii) are the most common species found in Sydney waters and are recognised by their distinctive black spikes.
    Photo credit: Marine Explorer via Foter.com / CC BY-NC-SA

    Photo credit: Marine Explorer via Foter.com / CC BY-NC-SA

    The mostly likely injury from any urchin species is a spine in you, especially from a black urchin as they are super-abundant in swimming, snorkeling and diving areas around Sydney.

    The Toxic flower urchin (Toxopneustes pileolus) has also been sighted around Sydney. It’s considered dangerous as it can deliver medically significant (and extremely painful) stings when touched – avoid touching!

    Other venomous urchins include Diademas and Sea lamingtons (Tripneustes gratilla).

    Photo credit: Misenus1 via Foter.com / CC BY-NC-SA

    Photo credit: Misenus1 via Foter.com / CC BY-NC-SA


    Photo credit: Marine Explorer via Foter.com / CC BY-NC-SA

    Photo credit: Marine Explorer via Foter.com / CC BY-NC-SA

    Diademas look very similar to the Black Sea Urchins, but are distinguished by the blue v-shaped flecks on the body and their much sharper, longer spines. Their spines have venomous tips.

    Sea lamingtons (Tripneustes gratilla) are usually found in tropical waters, however, they have been sighted in Sydney harbour. In general, they are a common, but not dangerous species.

  • OTHER

  • Shark Bites
    Shark encounters are incredibly rare, and when they do occur, often attract significant media attention. Thus, the risk of attack often appears much higher than it actually is.

    Data from the Australian Shark Attack File (ASAF) on shark attacks over the last 20 years, shows that shark fatalities remain low, at 1 fatality per year[note]West, John G. “Changing patterns of shark attacks in Australian waters.” Marine and Freshwater Research 62.6 (2011): 744-754[/note]. West 2011 also highlights that the seeming increase in attacks is related to an increasing human population and therefore increased water-use for recreation: “The increase in shark attacks over the past two decades is consistent with international statistics of shark attacks increasing annually because of the greater numbers of people in the water”.

    Most shark species are not dangerous. Even large species like the grey nurse shark (Carcharias taurus), where females can reach up to 2.2 m in length. It’s commonly thought that shark attacks on humans are mostly a case of mistaken identity; sharks thinking that a human is something else like a seal for instance (surfers from below resemble the shape of seals), and taking an exploratory bite. In most cases, the shark does not come back after one bite, and less than a third of attacks are fatal[note]West, John G. “Changing patterns of shark attacks in Australian waters.” Marine and Freshwater Research 62.6 (2011): 744-754[/note].

    Great White Shark. Photo credit: Elias Levy via Foter.com / CC BY

    Great White Shark. Photo credit: Elias Levy via Foter.com / CC BY


    Tiger Shark. Photo credit: kris-mikael.krister via Foter.com / CC BY

    Tiger Shark. Photo credit: kris-mikael.krister via Foter.com / CC BY


    Bull Shark. Photo credit: AlKok via Foter.com / CC BY-NC-SA

    Bull Shark. Photo credit: AlKok via Foter.com / CC BY-NC-SA

Prevention Preventing marine bites and stings

The Australian government has the following recommendations for avoiding marine bites and stings:

  • Swim at patrolled beaches between the red and yellow flags and inside stinger nets if they’re available.
  • Don’t enter the water when the beaches are closed.
  • Wear a full-body lycra suit for extra protection (particularly from tropical stingers during stinger season).
  • Don’t touch marine stingers if they are on the beach – they can still sting you.
  • Enter the water slowly to give marine stingers time to swim away.
  • Ask a lifeguard for help or advice if needed. While Box jellyfish are a significant threat, it can be reduced by covering up all bare skin (like wearing a thin rash suit) and in some areas swimming is simply avoided during the threat period (spring and summer).
  • Additional advice:
    • Do not deliberately provoke, disturb or touch marine wildlife.
    • Avoid turning over rocks in shallow water, especially with bare hands – this is when you can be bitten by animals like the blue ringed octopus.
    • If walking in shallow water, shuffle your feet sideways rather than stepping high – this moves Stingrays and stingarees out of the way if they are around and resting on the seafloor.
    • Obey instructions from lifeguards and landmanagers – do not enter the water if beach is closed.

Signs and symptoms Signs and symptoms of stings by marine species

After any marine bite or sting, seek medical help immediately if you experience:

  • Difficulty breathing
  • Difficulty remaining conscious
  • Chest pain
  • Swelling around the sting site
  • Vomiting
  • Spasms
  • Shock
  • Severe bleeding

For stingrays, symptoms include intense pain, nausea, weakness, and fainting. For tentacled creates, symptoms are rashes, blisters, headaches, chest pain, muscle pain, sweating and runny nose. For coneshells, reactions include swelling, numbness, blurred vision, and respiratory failure. In rare instances, a person may experience cardiac arrest.

Management management of stinging marine species

Adapted from St John’s Ambulance guidelines.

Pressure immobilisationCold compress (ice pack) Hot water Vinegar
Funnel-web and Mouse spidersbeesBlue-bottle (Pacific Man-O-War) jellyfishBox jellyfish
snakeswasps (European)Bullrout fishIrukandji jellyfish
Blue-ringed octopusantsCatfishJimble jellyfish
coneshellsticksCrown-of-Thorns starfishsea anenomes
sea snakesscorpionsStingraytropical marine stings of unknown origin
centipedesStonefish
Red-backed spidernon-tropical minor jellyfish
all other spiders

Pressure immobilisation

  1. Follow DRSABCD.
  2. Calm patient and keep still.
  3. Apply a pressure immobilisation bandage.
  4. Ensure call for help has been made—triple zero (000) – or emergency beacon activated.

Cold Compress

  1. Follow DRSABCD.
  2. Calm patient.
  3. Apply a cold compress or ice pack directly over the bite site to relieve the pain.
  4. Seek medical aid if necessary.

Hot Water Treatment:

  1. Follow DRSABCD.
  2. Calm patient.
  3. Place patient’s stung limb in hot water (as hot as you, the first aider, can tolerate).
  4. Ensure call for help has been made—triple zero (000) – or emergency beacon activated.

Vinegar Treatment:

  1. Follow DRSABCD.
  2. Calm patient.
  3. Flood stung area with vinegar for at least 30 seconds.
  4. If vinegar not available, flick tentacles off using a stick or gloved fingers.
  5. Ensure call for help has been made—triple zero (000) – or emergency beacon activated.

Special thanks to John Turnbull for reviewing and contributing to this article:
John Turnbull

Author of Marine Explorer and Ex-President of National Parks Association of NSW.

Infectious bites and scratches

Dealing with infectious bites and scratches

It's not the size of the dog in the fight, it's the size of the fight in the dog. Mark Twain

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Bites and scratches themselves usually aren’t a major concern in themselves (apart from drop bear bites), however, the potential for infection is the thing to watch out for, especially if the skin is broken.

Prevention Prevention of infectious animal bites and scratches

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WebMD make the following suggestions to prevent domestic and wild animal bites.

  • Do not disturb animals, even your family pets, while they are eating, sleeping, or nursing. Animal mothers can be very aggressive when protecting their young.
  • Never leave a young child or baby alone with a pet or wild animal.
    Do not approach or play with unfamiliar or stray pets or wild animals.
  • Teach children to ask permission from a pet’s owner before petting the animal. Do not pet an animal without first letting it sniff you.
  • Don’t run past a dog, because dogs naturally love to chase and catch things.
  • Many animals give a warning sign before they attack. If you have animals in your home, know their warning signs and teach them to your children.
  • Do not try to separate fighting animals. If available, water sprayed from a hose will often break up the fight.
  • If you see a threatening dog:
    • Stay still. Do not run.
    • Do not make direct eye contact with the dog or stare at the dog. Staring at a dog may be interpreted by the dog as a threat and aggression.
    • Don’t scream. If you say anything, speak calmly and firmly.
    • If you fall or are knocked to the ground, curl into a ball with your hands over your head and neck. Protect your face.
    • Notify animal control and, if possible, speak with the dog’s owners.
  • Tell children to report an animal bite to an adult immediately.
  • Do not keep wild animals as pets.
  • Do not touch or tease wild animals.
  • Do not handle sick or injured animals or animals that are acting strangely.
  • Get help from animal control personnel if you need to rescue a trapped or injured animal. If no help is available, wear the heaviest gloves and clothing you have. Do not move quickly when approaching the animal, and talk in a low, gentle voice to reassure the animal.

General Signs and Symptoms General Signs and Symptoms of infectious bites and scratches

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Bites can lead to the following injuries: puncture, lacerations, abrasions or scrapes, bruising and swelling.

Infection is the main concern, noted by swelling, redness, tenderness, pain around the wound, discharge, swollen lymph nodes, shivers and/or high temperature.

Management Management of infectious bites and scratches

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General bites
General management includes: stemming the flow of blood, and preventing infection. For any bite, tetanus may develop, so get checked by a healthcare professional who may administer a tetanus booster.

For serious bites, the Australian government health website recommends:

  • Carefully wash the body part that has been bitten off with tap water.
  • Place the part in a plastic bag or container which can be securely sealed.
  • Put the bag or container into iced water (do not place directly onto a block of ice) to keep it cool, as it may be possible to reattach the body part with surgery.
  • Go to your local emergency department immediately, taking the bag or container with you.

For minor bites, the Australian government health website recommends the following:

If the wound is still bleeding:

  • Cover it with a clean cloth then apply pressure with the palm of your hand, then keep the pressure on the wound for 15 minutes.
  • Apply pressure directly over the affected area with a pad made from a clean, rolled up piece of material such as a handkerchief or towel which should be dampened with clean water if possible, as this will reduce the amount of blood soaked up by the material.
  • Use a bandage to wrap around the pad or dressing. Do not wrap the bandage too tightly as it may affect the circulation.
  • If the bleeding is very heavy, it may seep through the bandage. You should use a second dressing to cover the first one.
  • If the bleeding continues through both bandages and pads, remove the second bandage only and apply a new one.
  • Do not look at the wound to see if it has stopped bleeding, in case removing the pressure causes it to start bleeding again.

If the wound is not bleeding:

  • Rinse under running water for two minutes. It might be easier for you to rinse your injury with a shower head, if possible. Pat dry with a clean cloth, then cover the wound with a dry, sterile, non-sticky dressing to help prevent infection.
  • Check the area daily for signs of infection such as increasing pain, redness, swelling or yellow discharge.
  • If you have not had a full course of tetanus immunisation or if your boosters are not up to date contact your doctor.
  • If you are in pain, get advice on medicines you can take from a pharmacist or a doctor.

Leech bites
There is currently no research into best practice for leech removal, so beware of websites and blog posts suggesting best methods to remove leeches! We have gathered some information on their removal and how to avoid them in the leech first aid article.

Dogs and cats
Bites usually occur if the animal is provoked, scared, unwell or protective of puppies. Treat wounds for infection and check tetanus. Likewise for human bites!

Bat bites
Australian bats carry lyssavirus, which has led to fatalities when passed onto humans. Early signs and symptoms are flu-like. The best prevention is to avoid handling bats, however, if you are accidentally bitten or scratched:

  • Immediately wash the wound thoroughly with soap and water for at least five minutes.
  • Apply an antiseptic solution or alcohol gel after washing.

Stinging plants

Dealing with stinging plants

Leaders grasp nettles. David Ogilvy

We are pretty familiar with insects and animals that bite and sting. The plant world also has a few unfriendly ways of arranging protection, with some making you itchy whilst others can leave you in pain for months. Soft-skinned walkers beware. It seems that Australia can boast that we have the most painful plant in the world, the Stinging Tree. Somehow this makes us a little proud….

Identification of Stinging Plants How to recognise stinging plants

Remember that it’s not just the living trees that sting, it’s dead leaves too. That means that if you spot a stinging plant, beware of leaf litter surrounding the area too.

Stinging trees are generally found in rainforest on the eastern parts of Australia. Australia has four common types: two that are large rainforest trees growing up to 30 to 35 m. The other two, only bushes often between 0.1 to 1m tall. All four species have a similar stinging mechanism but D. moroides (the Gympie Gympie) is generally considered to have the worst sting.

Gympie-gympie
(Dendrocnide moroides)
Common
names
stinging bush, gympie stinger,
mulberry-leaved stinger,
gympie gympie, gympie,
stinger or moonlighter
Tree heightaround 2 metres
Leaf sizelarge vaguely heart shaped
leaves (about the size of your
hand)
Link on WikiGympie-gympie

Giant stinging tree
(Dendrocnide excelsa)
Common
names
Australian nettle tree, fibrewood, gimpi gimpi, giant
stinging tree, gympie
Tree heightover 30 metres high
Leaf sizeleaves are large and heart shaped with serated edges,
however unlike the D. moroides, the D. excelsa’s leaves join the stalk at the notch between the overlapping lobes
Link on WikiGiant stinging tree
Locationfound in rainforests in NSW and southern QLD

Shiny leaf stinging tree
(Dendrocnide photinophylla)
Common
names
fibrewood, small-leaved nettle, mulberry-leaved
stinging tree, and gympie
Tree heightsimilar to the Giant stinging tree, but much narrower, up to 20 metres
Leaf sizeleaves are glossy on the upper surface, long and
narrow shaped (6-12 centimetres long) with wavy
or sometimes toothed margins
Link on WikiShiny leaf stinging tree
Locationfound in rainforests on the east coast of Australia between Sydney to Cooktown

Atherton Tableland stinger
(Dendrocnide cordata)
Common
names
gympie, stinger
Tree heightup to 4 metres
Leaf sizeheart shape leaves but with a broad notch at the base
which is inserted the leaf stalk
Locationfound on the Atherton Tablelands

As a general rule, if you are unsure or can’t remember the specific features of stinging trees, keep clear of plants with heart-shaped leaves with saw-toothed margins that look furry.

Other stinging plants are the ground-hugging nettles. They occur in many different environments, but particularly wet, shady areas.

Photo credit: janGlas via Foter.com / CC BY-NC-ND

Photo credit: janGlas via Foter.com / CC BY-NC-ND

The sting HOW DO THEY STING?

How do they sting?
The leaves and some branches and fruits of Stinging Tees are covered in tiny hairs, hollow silica needles that range in length from 0.2 to 2 millimeters. They look deceptively soft and furry, yet they are effectively glass hypodermic needles. Do not touch!

Interestingly, it seems that the pain is not just because of the needles but due to the fact they carry a neurotoxin. According to an ABC article “One scientist, Oelrichs, purified the poison and injected himself with it and suffered intense pain. He proved that the toxin, not the silicon hairs, caused the pain. If you have stabbed yourself with the hairs, you can release the neurotoxin from the hairs by heating or cooling your skin, or just touching it. This neurotoxin is very stable. Experiments have been done with hairs that were collected nearly a century ago, and they can still cause pain.” This article goes on to point out two interesting facts. Firstly, that the tree seems to have no effect on most Australian native animals. Secondly, and more interestingly, is that the plant does not seem to do any actual damage to your body. Unlike the venom from a snake or spider that causes damage to your body in many ways, this toxin seems to “just” cause pain.

Signs and symptoms – how bad is the sting?
The sting of Stinging Trees is pretty bad! In fact, after being stung by a stinging plant the pain can recur for more than two months. And it’s not just the living leaves that sting, dead leaves too can cause problems.

“Stinging trees (Gympie-Gympie) are the bane of people in the Australian tropical and sub-tropical coastal areas – especially after disturbances such as cyclones, which trigger the germination of seeds. It becomes quite an issue when children wander into small plants – and are really badly stung.”

Poisonous plants of Australia by Selwyn Everist (1974) has 684 pages – a lot of poisonous plants. At page 515 he says the following about stinging plants: “If the leaves or the twigs make direct contact with the skin, the hollow, silica-tipped hairs penetrate and there is at first a slight itch, followed in a few seconds by a severe prickling effect which quickly becomes intense pain of a complex nature. The pain is described … as composed of a background of tingling on which is superimposed an intermittent stabbing pain with sharp radiations passing in all directions.” He goes on to say the pain lasts for around eight hours (maybe 30 hours). The pain then can continue to recur for more than two months. More recent research cited by the ABC suggests that the “The pain comes immediately after touching the plant, and it gradually increases to a peak after about 20-30 minutes”. On top of this, it seems that some people can be allergic to the sting and suffer life-threatening anaphylactic shock, although deaths are very very rare.

Prevention
So let’s not allow these plants stop us from heading bush. Avoid the need for first aid by learning to spot these plants and giving them the respect they deserve. They are part of the Australian native ecosystem and deserve their space. Oh, and make sure you always have enough toilet paper so there is no risk of grabbing a leaf from one of these trees by mistake.

  • Know how to ID plants
  • Protective clothing: When walking in some areas, body armour could help :), but since the trees generally grow in warmer areas this has limited practical application. Long thick pants, a shirt and a hat can help protect from brushing against the leaves. Wearing thick gardening gloves will also reduce the risk of getting stung if your hands grab a leave or branch. Just be aware through that the clothes and gloves may collect needles whilst you are walking – so be mindful of this when removing and handling the clothing.

Management
Always work through the standard DRSABCD protocol. Avoid anyone else getting stung.

For stinging trees
The federal government healthdirect website suggests that you follow these four points:

  1. The most important thing is that you do not rub the area, as this can break off the hairs and make them very difficult to remove,
  2. Remove visible hairs with tweezers,
  3. Apply and remove adhesive tape or hair removal wax strip to the area to remove the finer hairs, and
  4. Do not scratch or rub the area, this may cause the hairs to penetrate deeper into the skin.

This simple treatment was developed in the 1990’s by Dr.Hugh Spencer of the Australian Tropical Research Foundation (AUSTROP). Although the original recommendation is to use the sugar-based depilatory “Waxeeze”, which is readily available from most pharmacies, any wax strip-based depilatory will work.

The rationale is to remove the hairs without disturbing them. Remove the visible hairs manually and then remove the remaining smaller hairs using wax strips. If the wax isn’t pre-applied to the strips, then first spread it onto cloth or strips. Do not apply wax directly to the skin because it’s likely that the hairs will break, causing immense pain to the patient, and making them hard or impossible to remove.

The use of pain relieving medication may also help reduce the signs and symptoms.

In 2013, AUSTROP published their updated protocol to deal with stinging trees via a blog post. They have had positive that applying a dilute solution of hydrochloric acid soaked in a cloth on the affected area will help neutralise the proteins. This is reported to be very painful for around 5-10 minutes but “the pain and after-sensitivity is completely gone in about 12 hours after treatment (as opposed to waiting for 3-6 months!)”. Although this method has been the subject of several student studies, the research base for it is very limited, and we strongly suggest that you speak with your doctor before trying this or before adding any hydrochloric acid to your first aid kit.

First Aid

A practical guide to useful first aid techniques

Take some time to learn first aid and CPR. It saves lives, and it works. Bobby Sherman

Here we go through some of the common procedures that can help when an emergency situation arises in the bush. We strongly recommend that you do a practical first aid course (e.g. BWRS to learn these techniques. This content on Bushwalking101 is a helpful refresher to those that have done a first aid course recently or an introduction for those planning to do one soon.

You’ll also need a good first aid kit.

The four first aid procedures that we’ll cover here are:

  • DRABCD
  • Shock
  • Wound cleaning
  • Anaphylactic shock

DRSABCD The 7 steps to manage any first aid scenario

For every first aid scenario, we follow a simple acronym developed by St John’s Ambulance: DRSABCD. By following each letter, we know the steps to take to ensure that we’re safe, and doing the best we can do under a stressful situation.

DRSABCD stands for:
DANGER: Ensure the area is safe for yourself, others and the patient
RESPONSE: Check for response—ask name—squeeze shoulders. If there’s response, make comfortable, check for injuries and monitor response. If there’s no response:

SEND FOR HELP: If in phone reception, call Triple Zero (000) for an ambulance or ask another person to make the call. If not in phone reception, trigger PLB.

AIRWAY: Check the airway isn’t blocked. Open mouth—if foreign material is present, place in the recovery position and clear airway with fingers. Open airway by tilting head with chin lift.

BREATHING: Check for breathing, look, listen and feel. If breathing is normal, place in recovery position, monitor breathing, manage injuries and treat for shock. If not normal breathing, start CPR.

CPR: Start CPR. Chest compressions are the most important part of CPR. The Australian and New Zealand Committee on Resuscitation (ANZCOR) make the following recommendations:
1. All rescuers should perform chest compressions for all persons who are unresponsive and not breathing normally.
2. Interruptions to chest compressions should be minimised.
3. Those who are trained and willing to give rescue breaths do so for all persons who are unresponsive and not breathing normally.

If you are alone, start chest compressions as soon as possible after calling for help, and aim for 30 compressions (almost two compressions per second) followed by two rescue breaths. Continue until help arrives.

DEFIBRILLATION: Apply defibrillator if available and follow voice prompts (unlikely to be available in the bush).

Shock First aid for shock

Shock is the body’s reaction to any kind of stressful situation. This could be triggered by a physical injury or an emotional state. Often, the exact way that stress presents is different from patient to patient, and scenario to scenario.

Immediately after injury, there may be little evidence of shock, but it may develop with time, depending on how severe the injury is and how quickly medical services can respond.

The signs and symptoms of shock include:

  • Weak, rapid pulse;
  • Cold, clammy skin;
  • Rapid breathing;
  • Faintness/dizziness;
  • Nausea;
  • Pale face, fingernails, lips.

St John’s Ambulance suggest the following protocol for dealing with stress:

  1. Follow DRSABCD and manage injuries such as severe bleeding.
  2. Reassure the patient.
  3. Raise the patient’s legs (unless fractured or a snake bite) above the level of the heart, with head flat on the floor.
  4. Treat any other wounds or burns, and immobilise fractures.
  5. Loosen tight clothing around neck, chest and waist.
  6. Maintain the patient’s body warmth with a blanket or similar. DO NOT use any source of direct heat.
  7. Give small, frequent amounts of water to the conscious patient who does not have abdominal trauma and who is unlikely to require an operation in the immediate future.
  8. Monitor and record breathing, pulse and skin colour at regular intervals.
  9. Place the patient in the recovery position:
    • If there is difficulty breathing;
    • If patient becomes unconscious;
    • If patient is likely to vomit.

Wound care First aid for wounds

Wounds can occur in many different ways: bites from animals, injury from objects, falls, scratches, lacerations and so on. In all cases, wound care by first aiders is about primarily stopping blood loss and secondarily preventing infection. Blood loss is the most important thing to sort first, preventing infection comes with longer term management of the wound.

For a serious wound, St John’s Ambulance makes the following recommendations:

  1. DRSABCD
  2. Lie casualty down if the bleeding is severe.
  3. Remove or cut clothing to expose the wound.
  4. Apply firm direct pressure or instruct casualty to do so if possible.
  5. If casualty is unable to apply pressure, apply pressure using a pad or your hands (use gloves if available).
  6. Raise and rest the injured part when possible.
  7. Apply a pad over the wound if not already in place and secure with bandage – ensure pad remains over the wound.
  8. If bleeding continues, leave initial pad in place and apply a second pad over the first and secure with a bandage.
  9. If bleeding continues replace second pad only.
  10. Seek medical aid. Doctors should examine open wounds for tetanus or other serious infections.

For minor wounds (e.g. grazes), to minimise the risk of infection, minor wounds they should be cleaned. St John’s Ambulance makes the following recommendations for cleaning a minor wound:

  1. Create a clean area in which to work e.g. a clean paper towel. Wash your hands and put on gloves. Wet the gauze swabs with the normal saline and clean the wound. There are three separate actions in cleaning the wound:
    • With a wet gauze, wipe the furthest section of the wound from you from top to bottom once only and discard used gauze into rubbish bag.
    • With the second wet gauze, clean the middle section using the same method.
    • Then with the third gauze swab, wipe the portion nearest to you, again, using the same method.
  2. Apply a non adherent dressing covering the whole wound. Discard gloves into rubbish bag.
  3. Then with the third gauze swab, wipe the portion nearest to you, again, using the same method.

Even if the wound is cleaned well, there is still a risk of infection as the wound heals. Patients should continue to change the dressing regularly (once per day) and if it gets dirty or wet and monitor for infection. Signs and symptoms of infection include localised pain, redness, swelling, offensive discharge, and the wound not healing. In these cases, seek medical attention.

Allergy and Anaphylaxis First aid for Allergy and Anaphylaxis

An allergy is a reaction that the body has against certain substances like pollen, gluten and peanuts. An allergy can be as mild as a slight swelling or discolouration of the skin, right through to the patient having difficulty breathing. In the case of the later, an allergy can be life threatening.

Anaphylaxis is the term used to describe a severe allergic reaction, which must always be treated as a medical emergency.

Signs and symptoms of a mild to moderate allergic reaction (may precede anaphylaxis) may include:

  • Swelling of the lips, face, eyes;
  • Hives or welts;
  • Tingling mouth;
  • Abdominal pain and vomiting.

Any one of these signs and symptoms may indicate anaphylaxis:

  • Difficulty and/or noisy breathing;
  • Swelling of the tongue;
  • Swelling/tightness of the throat;
  • Difficulty talking and/or hoarse voice;
  • Wheezing and/or coughing;
  • Persistent dizziness or collapse;
  • Young children may be pale and floppy.

St John’s Ambulance recommend the following management for anaphylaxis:
For an unconscious patient:

  1. Follow DRSABCD.
  2. Immediately administer the adrenaline autoinjector, if available.

For a conscious patient:

  1. Follow DRSABCD.
  2. Help patient to sit or lie in a position that assists breathing.
  3. If the patient is carrying an auto-injector (e.g. Epipen®, AnaPen®), it should be used at once. Let the patient administer the auto-injector themselves, or ask if they require assistance.
  4. Keep the patient in a lying or sitting position. Observe and record pulse and breathing.
  5. If no response after 5 minutes, further adrenaline may be given.

Bites and Stings First Aid

A practical guide to useful first aid techniques to deal with bites and stings

There are four techniques that are used to manage bites and stings: pressure immobilisation, ice pack, hot water and vinegar. Each are specific to the type of species that the bite/sting came from, but in all cases we follow DRSABCD, first making sure that the patient and other people in the group are safe.

If you know what animal bit or stung the patient, follow procedures specific to that animal group. Use this Quick and easy table of reference from St John Ambulance to work out the technique to use:

TechniqueSpeciesManagement Actions
Pressure bandage with immobiliseFunnel-web and Mouse spiders, snakes, Blue-ringed octopus, coneshells and sea snakes 1. Follow DRSABCD.
2. Calm patient and keep still.
3. Apply a crepe bandage over bite site.
4. Firmly apply a heavy crepe pressure bandage, starting at the fingers/toes and working up as far as possible.
5. Immobilise the bandaged limb using splints.
6. Ensure 000 has been called or emergency beacon activated.
Ice pack (cold compress) Red-back spiders (and others not mentioned above), bees, European wasps, ants, ticks, scorpions, centipedes 1. Follow DRSABCD.
2. Calm patient and keep still.
3. Apply an ice pack directly over the bite site to relieve the pain.
4. Seek medical attention if necessary
Hot waterBlue-bottle (Pacific Man-O-War) jellyfish, Bullrout fish, Catfish, Crown-of-Thorns starfish, Stingray, Stonefish and nontropical minor jellyfish1. Follow DRSABCD.
2. Calm patient.
3. Place patient’s stung limb in hot water (as hot as you, the first aider, can tolerate).
4. Ensure 000 has been called or emergency beacon activated.
Vinegar Box, Irukandji and Jimble jellyfish, sea anemones and tropical marine stings of unknown origin 1. Follow DRSABCD.
2. Calm patient.
3. Flood stung area with vinegar for at least 30 seconds.
4. If vinegar is not available, flick tentacles off using a stick or gloved fingers.
5. Ensure 000 has been called or emergency beacon activated.

After the incident, ensure that the patient has a current tetanus vaccination. In some cases, pain relief is appropriate g. paracetamol or an antihistamine (to reduce swelling, redness and itch), but consult with a medical professional first.

If you are unsure what animal bit or stung you, apply a precautionary approach, and manage it as though it is a venomous bite, and seek medical help immediately.

The four procedures we’ll cover here are:

  • Pressure immobilisation, to reduce the movement of venom in the lymphatic system.
  • Ice pack for pain management by reducing the flow of blood to the affected area and reducing inflammation and swelling that causes pain.
  • Hot water & vinegar to denature the protein in the stinger.

Pressure Immobilisation Applying a pressure immobilisation bandage

The pressure immobilisation technique was developed in the 1970s as a technique to slow the movement of venom throughout the body. Research has shown that when pressure is applied to the bite area, less venom reaches the bloodstream.

Pressure immobilisation is appropriate for bites from Funnel-web and Mouse spiders, snakes, Blue-ringed octopus, cone shells and sea snakes. Do not use pressure-immobilisation for spider bites other than from a funnel web spider, jellyfish stings, stonefish and other fish stings, bites by scorpions, centipedes, beetles.

This video from the Australian venom research unit shows how to pressure immobilise a lower limb.

For bites to the lower limb, the Australian venom research unit suggests the following steps:

  1. DRSABCD, send for help by calling 000 if in reception, or triggering an emergency beacon.
  2. Apply a broad pressure bandage over the bite site as soon as possible. Crepe bandages are ideal, but any flexible material may be used. Clothing, towels etc may be torn into strips. Panty hose have been successfully used. Do not take off clothing, as the movement of doing so will promote the movement of venom into the bloodstream. Keep the bitten limb, and the patient, still. Bandage upwards from the lower portion of the bitten limb. Even though a little venom may be squeezed upwards, the bandage will be more comfortable, and therefore can be left in place for longer if required.
  3. The bandage should be as tight as you would apply to a sprained ankle.
  4. Extend the bandage as high as possible up the limb.
  5. Apply a splint to the leg. Any padded rigid object may be used as a splint. E.g. spade, piece of wood or tree branch, rolled up newspapers etc – with towel or clothing as padding.
  6. Bind it firmly to as much of the leg as possible. Keep the patient still and relaxed. Lie the patient down to prevent walking or moving around. Monitor patient and wait for rescue services to arrive.

For bites to other parts of the body, the Australian venom research unit suggests the following.

In all cases, follow DRSABCD, call 000 or trigger an emergency beacon.

Bites to the hand or forearm
Bandage as much of the arm as possible, starting at the fingers. Use a splint to the elbow.
Use a sling to immobilise the arm. Keep the patient still. Lie the patient down to prevent movement walking or moving around.

Bites to trunk
If possible apply firm pressure over the bitten or stung area. Do not restrict chest movement. Keep the patient still.

Bites to head or neck
No first aid for bitten or stung area. Keep the patient still.

DOs and DON’Ts
The Australian venom research unit also makes the following points:

  • DO keep the patient still and limit patient transportation as much as possible.
  • DO apply pressure-immobilisation first aid even if the venom appears to have already got into the bloodstream: the application of pressure-immobilisation first aid may prevent further absorption of venom from the bite or sting site during transport to hospital.
  • DO keep bandages and splints on until the patient reaches medical care.
  • DO NOT cut or incise the bitten area.
  • DO NOT apply an arterial tourniquet. (Arterial tourniquets, which cut off the circulation to the limb, are potentially dangerous, and are no longer recommended for any type of bite or sting in Australia.)
  • DO NOT wash the bitten area or suck the bite. The type of snake involved may be identified by the detection of venom on the skin. If the snake can be safely killed, bring it to the hospital with the victim.

Ice Pack Applying an Ice Pack

Cold therapy is used for pain management. The idea is to use ice to reduce the flow of blood to the affected area and reducing inflammation and swelling that causes pain.

An ice pack is a plastic sack filled with liquid or gel that can be used to treat injuries including bites and stings, swelling and sprains. Ice packs are generally kept in refrigerators and are often seen in an urban context at sporting competitions.

For remote areas, people can carry instant ice packs instead. These ice packs consist of two separate bags containing ammonium nitrate, calcium ammonium nitrate or urea. When the user breaks the seal between the two bags, the contents mix and cause an endothermic reaction to occur which sucks all the warmth from the surroundings and lowers the ice pack temperature.

Ice packs should be used for red-back spiders (and other spiders excluding Funnel-web and Mouse spiders), bees, European wasps, ants, ticks, scorpions, centipedes. In general, these species cause painful bites, but generally do not lead to medical complications.

For ice pack treatment, St John’s ambulance suggests:

  1. Follow DRSABCD (in most cases, SABCD parts are not required).
  2. Apply a cold compress or ice pack directly over the bite site to relieve the pain.
  3. Seek medical aid if necessary.

Hot Water Applying Hot Water

Hot water helps to relieve some types of stings by denaturing and inactivating the venom.

For some marine species, immersing the sting area in hot water provides relief, and is the recommended first aid for the following species by St John’s Ambulance: Blue-bottle (Pacific Man-O-War) jellyfish, Bullrout fish, Catfish, Crown-of-Thorns starfish, Stingray, Stonefish and nontropical minor jellyfish. These species can cause fatalities and an emergency 000 call or activation of an emergency beacon must be made.

St John’s Ambulance suggests the following steps:

  1. Follow DRSABCD action plan.
  2. Calm patient.
  3. Place patient’s stung limb in hot water (around 40 ℃). Beware the injured person will have an a distorted sense of pain, so the temperature must be as much as the first-aider can tolerate without causing burns.
  4. Ensure call for ambulance has been made – triple zero (000) – or emergency beacon activated.

Vinegar Applying Vinegar

Likewise, vinegar helps to relieve other types of stings by denaturing and inactivating the venom.

The species that vinegar is the recommended treatment for include:
Box, Irukandji and Jimble jellyfish, sea anemones and tropical marine stings of unknown origin.

St John’s Ambulance suggests the following steps:

  1. Follow DRSABCD action plan.
  2. Calm patient.
  3. Flood stung area with vinegar for at least 30 seconds.
  4. If vinegar not available, flick tentacles off using a stick or gloved fingers.
  5. Ensure call for ambulance has been made – triple zero (000) – or emergency beacon activated.

What is a PLB?

Information on PLBs

I can't change the direction of the wind,
but I can adjust my sails to always reach my destination. Jimmy Dean

A Personal Locator Beacon (PLB) is a small emergency device used in a situation that the group has deemed life-threatening. This could include pre-existing medical issues such as a condition or diabetes that flare up, or severe injuries like head injuries or snake bite. It is lightweight, small and practical, suitable for bushwalkers to carry on their person.

Most PLBs contain a Global Positioning System (GPS) to report the location, making it easier and faster for emergency services to respond appropriately.

When activated, a PLB transmits a distress signal which is detected world-wide by the global satellite system, Cospas-Sarsat, and is then relayed to the appropriate emergency services. The emergency services then dispatch a rescue team to the coordinates the beacon transmitted. Exactly how the response team is dispatched, and how quickly is can reach the party, depends on the terrain and weather conditions. Helicopters, for instance, can only operate under clear weather conditions. Sometimes a response party is sent in by foot, which means the response times vary and you still need to be prepared to wait.

As well as transmitting the PLB’s ID and location via satellite the PLB also transmits a homing signal for the search and rescue team. This can make it easier to find the PLB in dense vegetation and around cliffs.

PLBs are a single use device and the battery must be replaced after it has been activated.

How is a PLB different to an EPIRB or an ELT? Know what’s appropriate for bushwalking

PLB’s are part of a larger family of devices called ‘Distress Beacons’. They are heavily regulated devices and are required to meet very strict requirements. Sometimes you hear the names for different devices used incorrectly.

EPIRBs (Emergency Position Indicating Radio Beacons) are used in ships and boats, and are designed to float upright in using the water plane as a reflector to more efficiently get the signal to the satellite. EPIRBs are required to adhere to State and Territory Marine regulations, and their required size and weight make them impractical to be used for bushwalking.
Note: A PLB is not a substitute for a Marine EPIRB.

ELT (Emergency Locator Transmitters) are designed for aviation use. They are fixed units in aircraft and automatically activated when an aircraft crashes. Again they are too large and heavy for bushwalkers.

EPIRBs and ELTs are designed to stay with your vehicle (car, boat or aircraft). You may, as an additional safety measure, choose to carry a PLB, in the event where you become separated from your vehicle.

How a PLB works?

Background information on how a PLB sends a signal

Live as if you were to die tomorrow.
Learn as if you were to live forever. Mahatma Gandhi

Understanding how a PLB works will help you think through where and when to activate the device.

All distress beacons (PLBs, EPIRBs and ELTs) send signals on dedicated world-wide frequencies. The signals are received by the COSPAS SARSAT satellites, the international satellite system for search and rescue (SAR).

Image courtesy of http://beacons.amsa.gov.au/about/how-they-work.asp

Image courtesy of http://beacons.amsa.gov.au/about/how-they-work.asp

Using the sequence in the diagram above:

  1. A distress signal is transmitted from a PLB/EPIRB/ELT.
  2. The signal is received by the COSPAS SARSAT satellites.
  3. The satellites send the signal to the nearest receiving stations on earth known as Local User Terminals (LUTs).
  4. A Local User Terminal forwards the message to a Mission Control Centre (MCC).
  5. When a signal is received and identified to be a distress call from Australia the Rescue Coordination Centre (RCC) in Canberra is alerted.

The appropriate emergency service for the distress call is then activated. In the case of bushwalkers this is a land rescue and therefore the Police is the responsible authority. The Police would activate emergency services as required to locate and rescue the walker in distress – usually a rescue helicopter.

In the Australian search and rescue region there are three LUTs located at Albany (WA), Bundaberg (QLD) and Wellington (NZ) that are controlled by the MCC located within the Australian Joint Rescue Coordination Centre (JRCC) in Canberra.

For a video presentation of the rescue process please check out this youtube video by ACR Artex.

Locating the PLB How the signal is located

(Information adapted from http://www.sarsat.noaa.gov/faq%202.html)

A satellite in a geostationary orbit is at an altitude of 22,300 miles (35,890 kilometers). The satellite moves in a circular orbit in the equatorial plane around the Earth at the same speed that the Earth rotates. Because of this, it appears to remain over a fixed point on the Earth’s surface. This position is ideal for making uninterrupted observations of the weather or environmental conditions in a given area. This same principle allows it to monitor for 406 MHz distress beacons. However, satellites in geostationary orbit cannot see the polar regions of the world.

A low earth/polar orbit allow the satellites to observe the entire Earth’s surface as it rotates beneath it. Most of these orbits are at an altitude of 500 miles (800 km) and take about 100 minutes to revolve around the earth. The sun-synchronous orbit is a special case of a polar orbit with inclination of 98.7 degrees, that precesses at exactly the required rate (~ 1 degree per day) to remain in the same local time plane as the Earth rotates around the sun. Satellites in polar orbit provide emergency beacon users with global coverage (including the Polar Regions).

There are three ways that a PLB can be located by authorities:

  1. By the device transmitting the GPS location.
  2. Satellites calculating location using Doppler effect.
  3. The use of the homing signal by aircraft or ground crew.

If a 406 MHz emergency beacon is equipped with a Global Position System (GPS) receiver, the digital message transmitted by the beacon can contain the GPS-generated position of the beacon. This is a common feature of modern PLB devices. Once the signal has been picked up by satellites, emergency services can dispatch to the exact location quickly.

In the absence of GPS coordinates being transmitted, Low Earth Orbiting Search and Rescue (LEOSAR) satellites can compute a location for a 406 MHz emergency beacon using a method called “Doppler shift”. When the beacon is moving toward or away from the satellite track due to the Earth’s rotation, the frequency shift induced by that motion can be used to compute location. Computing a location using Doppler shift requires the satellite to be moving, that is, the satellite cannot be in a geostationary orbit (GEOSAR).

Because their geostationary orbit does not provide a relative motion between a distress beacon and a GEOSAR satellite, there is no opportunity to use the Doppler effect to calculate the location of a beacon. Therefore, the GEOSAR satellites only can relay a beacon’s distress message. The LEOSAR satellites also provide global coverage, including the Polar Regions, for 406 MHz emergency beacon detection.

Many 406 MHz emergency beacon are also equipped with a 121.5 MHz ‘homing’ frequency, what aircraft overhead can use to locate the device. This is a separate signal to the 406 MHz distress signal, and can also be used by land crew to locate the device.

Timing How long does it take to be rescued?

Prepare for a long wait….

The time it takes for search and rescue personnel to reach you depends on a number of factors, including the weather, terrain and accessibility of your location. The more remote the location of the distress incident, the longer the response time. Whether your PLB is registered and GPS equipped also play a very important role.

Checklist after activation Dos and Don’ts

Do stay with the PLB as this is the location that the emergency services will use to locate the casualty. Wandering off attempting to find your way home will only delay rescue.

Don’t turn off the PLB, even if you no longer need rescuing. If the signal fails, the rescue team may assume your PLB battery has expired and commence a blind search. If you triggered the PLB by mistake or no longer need assistance do your best to contact emergency service and let them know what happened, they will direct you to switch it off.

Do leave the PLB on until directed to turn off by the emergency services. If you have not been located yet then leave it on until the battery goes flat.

In a group
If you are in a group, do not activate more than one beacon at a time. When the first beacon’s battery goes flat then turn it off and activate the second one. You will not get a stronger signal by activating two beacons at the same time – the transmissions actually interfere with one another and make it harder to find you. The battery life of a PLB is more than 24 hours, it is unlikely that rescue will take that long to arrive.