Articles:
Upper Respiratory Infections: When to Use an Antibiotic:
Colds, sinus infections, pharyngitis / tonsillitis and bronchitis are included among the category of Upper Respiratory Infections (URI). Sinus infections often have symptoms of nasal drainage, sinus pressure, cough and fever. Pharyngitis symptoms may include sore throat, fever, headaches and abdominal pain. Bronchitis mostly shows up as a cough with little or no drainage nor headache. It is often difficult to tell which of these you might have, because there can be overlapping of symptoms.
These complaints are among the most frequent causes for visits to an Urgent Care Clinic. Viruses, not bacteria, cause the vast majority of these infections. This is important to know because we cannot treat a virus with an antibiotic, only bacteria respond to antibiotic treatment. The major task of the physician is to determine if a virus or bacterial infection brings on the illness. In addition to the symptoms, the physician relies on the physical exam to confirm which type of organism is the cause of the symptoms.
The use of antibiotics in these infections has become a hot topic in the medical field over the last several years because bacteria have developed increasing resistance to antibiotics. Resistances to drugs shows up when bacteria can’t be killed by antibiotics and take over when the weaker bacteria are killed. This is largely due to the overuse of antibiotics – that is, using an antibiotic to treat a viral infection or using an antibiotic that is not effective against the bacteria causing the infection.
How can we best determine if a bacterial infection is present and an antibiotic may be helpful? No matter how severe the symptoms, antibiotics are indicated only when:
As you can see, it is important, when visiting the doctor’s office, to make sure to ask for and expect an antibiotic only when it is indicated by the presence of a bacterial infection. You will have a much higher chance of getting better now and in the future.
References: www.aafp.com | www.aware.com
www.cdc.gov/drugresistance/community
These complaints are among the most frequent causes for visits to an Urgent Care Clinic. Viruses, not bacteria, cause the vast majority of these infections. This is important to know because we cannot treat a virus with an antibiotic, only bacteria respond to antibiotic treatment. The major task of the physician is to determine if a virus or bacterial infection brings on the illness. In addition to the symptoms, the physician relies on the physical exam to confirm which type of organism is the cause of the symptoms.
The use of antibiotics in these infections has become a hot topic in the medical field over the last several years because bacteria have developed increasing resistance to antibiotics. Resistances to drugs shows up when bacteria can’t be killed by antibiotics and take over when the weaker bacteria are killed. This is largely due to the overuse of antibiotics – that is, using an antibiotic to treat a viral infection or using an antibiotic that is not effective against the bacteria causing the infection.
How can we best determine if a bacterial infection is present and an antibiotic may be helpful? No matter how severe the symptoms, antibiotics are indicated only when:
- Symptoms persist longer than 7 - 10 days, or
- Symptoms are progressively worse after 7 days, or
- Fever is present after 5 days, or
- Patients have a poor immunity to infection (e.g. HIV/AIDS, cancer), or
- Patients have poorly controlled diabetes.
- Pharyngitis is caused by Streptococcal infection (this is detected by the rapid strep test often done in the doctor’s office).
As you can see, it is important, when visiting the doctor’s office, to make sure to ask for and expect an antibiotic only when it is indicated by the presence of a bacterial infection. You will have a much higher chance of getting better now and in the future.
References: www.aafp.com | www.aware.com
www.cdc.gov/drugresistance/community
Burns: What to Do Immediately to Minimize the Injury:
Burns are common injuries and can happen daily in our life. We need to know what to do immediately to minimize the injury when it happens and how to distinguish a minor burn from severe burn. The treatment of a burn injury depends on the cause, the depth, the size and the location.
CAUSES
The common causes include heat (flame, tar, melted synthetics, molten metal and liquid), electricity, chemical agents (melt tissues) and radiation.
DEGREE
The skin has two layers: epidermis and dermis. First-degree burn is superficial and only the epidermis (outer layer of skin) is burned. The skin appears red, swollen and painful. Second-degree burn injury may look similar to the first-degree burn early on, but both epidermis and dermis (inner layer of skin) are burned. Blisters develop and the pain is more intense. Third-degree burn involves the full thickness of skin. The skin appears dry, pearly white, charred, leathery and loses its sensation, becoming numb.
TREATMENT
First-degree burns and some second-degree burns (less than 2-3 inches in diameter and not on hands, feet, face, groin, buttocks or joints), the following steps should be taken as the initial management:
All third degree burns and second degree burns which are located on hands, feet, face, groin, buttocks and joints need immediate medical evaluation. The patient should be treated in an adequate medical facility. Special topical antiseptic creams (silver sulfadiazine and mafenide acetate creams) are used for more severe burns.
Sources: The Family Practice Handbook, University of Iowa, Mosby and www.Mayoclinic.com
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CAUSES
The common causes include heat (flame, tar, melted synthetics, molten metal and liquid), electricity, chemical agents (melt tissues) and radiation.
DEGREE
The skin has two layers: epidermis and dermis. First-degree burn is superficial and only the epidermis (outer layer of skin) is burned. The skin appears red, swollen and painful. Second-degree burn injury may look similar to the first-degree burn early on, but both epidermis and dermis (inner layer of skin) are burned. Blisters develop and the pain is more intense. Third-degree burn involves the full thickness of skin. The skin appears dry, pearly white, charred, leathery and loses its sensation, becoming numb.
TREATMENT
First-degree burns and some second-degree burns (less than 2-3 inches in diameter and not on hands, feet, face, groin, buttocks or joints), the following steps should be taken as the initial management:
- Remove any constricting jewelry and contaminated clothing.
- Cool the burn with cold running water for at least 5 minutes or until pain subsides. Chemical burn should be washed with tap water for at least 15 and preferably 30 minutes. DO NOT put ice on the burn.
- Cover with a sterile gauze bandage.
- DO NOT put butter or oils on the burn.
All third degree burns and second degree burns which are located on hands, feet, face, groin, buttocks and joints need immediate medical evaluation. The patient should be treated in an adequate medical facility. Special topical antiseptic creams (silver sulfadiazine and mafenide acetate creams) are used for more severe burns.
Sources: The Family Practice Handbook, University of Iowa, Mosby and www.Mayoclinic.com
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Cold Hands & Feet: Frostbite:
When body parts get too cold, they can be injured or react in different ways. The most severe cold injury is called frostbite. When frostbite occurs, the tissues freeze and form ice crystals. With this, permanent damage occurs to the blood vessels and other structures. With frostnip ice crystals also form in the tissue, but it only occurs in the outer layers of the skin. No permanent damage results from frostnip. Immersion injury happens when hands or feet are exposed to water that is at or above freezing. Damage to the muscles and nerves can develop over a period of hours or days. This may result in permanent damage.
Frostbite shows up as white, hard or waxy tissue. Frostnipped tissue is also white, but not hard and it generally involves very small areas. Frozen parts have no feeling. They may tingle or feel like a “block of wood”.
Once frostbitten areas thaw, they may be painless or tingle. When they are rewarmed rapidly by warm water (preferred method), they may be painful. Over the next few days, the injured parts may be painful and swollen. Blisters may appear and most severely injured areas may turn black.
Immersion injuries are first red, then become pale and swollen. Numbness or painful tingling sometimes occurs. After the first few days, an immersed part becomes very red, tingle, swells, and may develop blisters or skin breakdown. If any of these signs or symptoms occurs, go immediately to an emergency facility.
Steps you can take until you are able to get to an emergency room are:
Prevention is very important:
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Frostbite shows up as white, hard or waxy tissue. Frostnipped tissue is also white, but not hard and it generally involves very small areas. Frozen parts have no feeling. They may tingle or feel like a “block of wood”.
Once frostbitten areas thaw, they may be painless or tingle. When they are rewarmed rapidly by warm water (preferred method), they may be painful. Over the next few days, the injured parts may be painful and swollen. Blisters may appear and most severely injured areas may turn black.
Immersion injuries are first red, then become pale and swollen. Numbness or painful tingling sometimes occurs. After the first few days, an immersed part becomes very red, tingle, swells, and may develop blisters or skin breakdown. If any of these signs or symptoms occurs, go immediately to an emergency facility.
Steps you can take until you are able to get to an emergency room are:
- Remove wet clothing.
- Do not try to thaw the frozen part unless you are in a warm place because refreezing causes more damage.
- Treat frozen parts gently, don’t rub them.
- Warm the frozen body parts in warm (not hot) water for about 30 minutes. Do not use dry heat (fireplaces, ovens or heating pads) to thaw frostbite.
- Make sure to warm the entire body, not just the frostbitten parts. Wrap the rest of the body in blankets.
- Place clean cotton balls between frostbitten fingers and toes after they have been rewarmed.
- Do not break any blisters.
- Loosely wrap rewarmed areas with clean bandages to keep from refreezing.
- Ibuprofen may be used for pain.
- Get to an emergency facility as soon as you can.
Prevention is very important:
- Keep warm in cold weather.
- Wear loose fitting clothes in layers. Wear insulated boots, thick socks and gloves or mittens (mittens are warmer than gloves).
- Protect the face, hands, and feet, especially in windy, cold conditions.
- Keep hands and feet dry.
- Don’t wear extra socks if they make the boots too tight.
- Do not smoke, as this causes poor circulation to the hands and feet.
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Sports Physical: What is It and Why Does My Child Need One?
The Requirement
A sports physical is also known as the pre-participation examination (PPE). The Michigan High School Athletic Association (MHSAA) requires all students who participate in Middle School or High School athletics to have a sports physical on file before participation. The major medical societies* that make recommendations for the medical care of youth agree there is value in having yearly sports physicals.
The Purpose
The sports physical is not a random requirement of the MHSAA but rather a very purposeful, focused visit with a physician. The goal of the sports physical is to identify health issues of student-athletes to avoid placing them at risk during practice or competition. Examples include: an undiagnosed heart murmur, an ankle sprain that has not fully healed, untreated exercise-induced asthma, or a history of multiple concussions. On the rare occasion that a health condition is identified, the next step is to provide appropriate referral for further evaluation and treatment in preparation for participation in sport.
Timing
The ideal time to have a sport physical is 1-2 months prior to tryouts or practice. This provides time for any problem that may arise, to be further evaluated or treated; allowing the student-athlete to begin participation on time.
The Form
Often, your school will provide you with a form to be completed both by the student-athlete’s parent and the physician. It is helpful to have your portion of the card completed when you arrive for your physical. If you do not have a form, we can provide you with one.
The Examination
During the sports physical the medical assistant will measure height, weight, blood pressure, heart rate, and vision. The doctor will review these measurements, ask the student-athlete and parent about medical history and perform the physical exam. The student-athlete’s medical history and family medical history are very important parts of the sports physical process. It is ideal to have the student-athlete accompanied by a parent to provide a complete history. The physical exam is a brief exam of the eyes, ears, nose, throat, heart, lungs, and abdomen, as well as joints, nerves, and skin. Males (and some females) will also have a hernia exam. Because the physician needs to examine the skin and joints, it is helpful to wear shorts and for females to wear a sports bra or sleeveless shirt.
*American Academy of Family Physicians, American Academy of Pediatrics, American Medical Society of Sports Medicine, American College of Sports Medicine, and American Orthopedic Society for Sports Medicine, and American Osteopathic Academy of Sports Medicine.
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A sports physical is also known as the pre-participation examination (PPE). The Michigan High School Athletic Association (MHSAA) requires all students who participate in Middle School or High School athletics to have a sports physical on file before participation. The major medical societies* that make recommendations for the medical care of youth agree there is value in having yearly sports physicals.
The Purpose
The sports physical is not a random requirement of the MHSAA but rather a very purposeful, focused visit with a physician. The goal of the sports physical is to identify health issues of student-athletes to avoid placing them at risk during practice or competition. Examples include: an undiagnosed heart murmur, an ankle sprain that has not fully healed, untreated exercise-induced asthma, or a history of multiple concussions. On the rare occasion that a health condition is identified, the next step is to provide appropriate referral for further evaluation and treatment in preparation for participation in sport.
Timing
The ideal time to have a sport physical is 1-2 months prior to tryouts or practice. This provides time for any problem that may arise, to be further evaluated or treated; allowing the student-athlete to begin participation on time.
The Form
Often, your school will provide you with a form to be completed both by the student-athlete’s parent and the physician. It is helpful to have your portion of the card completed when you arrive for your physical. If you do not have a form, we can provide you with one.
The Examination
During the sports physical the medical assistant will measure height, weight, blood pressure, heart rate, and vision. The doctor will review these measurements, ask the student-athlete and parent about medical history and perform the physical exam. The student-athlete’s medical history and family medical history are very important parts of the sports physical process. It is ideal to have the student-athlete accompanied by a parent to provide a complete history. The physical exam is a brief exam of the eyes, ears, nose, throat, heart, lungs, and abdomen, as well as joints, nerves, and skin. Males (and some females) will also have a hernia exam. Because the physician needs to examine the skin and joints, it is helpful to wear shorts and for females to wear a sports bra or sleeveless shirt.
*American Academy of Family Physicians, American Academy of Pediatrics, American Medical Society of Sports Medicine, American College of Sports Medicine, and American Orthopedic Society for Sports Medicine, and American Osteopathic Academy of Sports Medicine.
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Sprains, Strains and Fractures: How to Treat These Common Injuries:
Participating in exercise and sports is beneficial for the health of children and adults. However, athletic participation is occasionally associated with injury. Injuries also can occur due to accidents associated with daily activities. It is important to recognize when an injury is serious and requires immediate medical attention. It is also important to understand that injuries in children can be very different that those in adults.
A Strain is an injury to a muscle that occurs when it has been stretched too far. Muscle is connected to bone by tendons. Strains take about 1 week to heal.
A Sprain occurs when a ligament is over-stretched or torn. Ligaments are strong elastic bands of tissue that connect bone to bone at joints (like the elbow, knee, or ankle). Sprains often take 3 to 4 weeks to heal and may require a splint for part of the healing time.
A Fracture is a broken bone. Most fractures take 4 to 6 weeks to heal. Fractures, typically, are treated by immobilizing the injured area with a splint or cast.
RECOGNIZING SERIOUS INJURY
The following symptoms or situations may indicate a serious injury:
WHAT TO DO IF YOU THINK AN INJURY IS SERIOUS – RICE:
REST: Stop or reduce use of the injured area. If injury is to leg, ankle or foot this may mean staying off of it completely.
ICE: Place an ice pack on the injured area for 15-20 minutes every 2-3 hours. A bag of ice wrapped in a thin towel works well. This is usually for the first 24-48 hours after the injury.
COMPRESSION: Compression or an injured wrist, ankle, or knee can help reduce swelling. This is often accomplished by using an elastic wrap (ACE wrap).
ELEVATION: try to keep the injured area above the heart, relative to the ground to minimize the swelling.
Do not apply heat to the area of injury for the first 48 hours. Seek immediate medical treatment. A doctor will evaluate your injury to see if an X-ray of the injured area is needed, and provide treatment and pain relief.
INJURIES IN CHILDREN
How are children’s injuries different than those in adults?
Children are actively growing. The areas in a child’s bone where growth is taking place is called a growth center or a growth plate. These growth centers often are more likely to be injured than surrounding muscles or ligaments. With an injury, in which an adult may sustain a sprain or strain, a child is much more likely to injure a growth center in a bone. A child sustaining an injury that causes pain or swelling should be examined by a physician and may need X-rays. Injury to a bone’s growth center is treated like a fracture with splinting or casting and may take several weeks to heal.
Source: American Academy of Family Physicians, American Academy of Pediatrics, American Medical Society of Sports Medicine, American College of Sports Medicine, and American Orthopedic Society for Sports Medicine, and American Osteopathic Academy of Sports Medicine.
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A Strain is an injury to a muscle that occurs when it has been stretched too far. Muscle is connected to bone by tendons. Strains take about 1 week to heal.
A Sprain occurs when a ligament is over-stretched or torn. Ligaments are strong elastic bands of tissue that connect bone to bone at joints (like the elbow, knee, or ankle). Sprains often take 3 to 4 weeks to heal and may require a splint for part of the healing time.
A Fracture is a broken bone. Most fractures take 4 to 6 weeks to heal. Fractures, typically, are treated by immobilizing the injured area with a splint or cast.
RECOGNIZING SERIOUS INJURY
The following symptoms or situations may indicate a serious injury:
- Tenderness (it hurts to touch) over a bone
- Swelling
- Pain in a joint
- Decreased motion in a joint
- Unable to put weight on a foot or leg
- Numbness, tingling, or weakness of the injured part
WHAT TO DO IF YOU THINK AN INJURY IS SERIOUS – RICE:
REST: Stop or reduce use of the injured area. If injury is to leg, ankle or foot this may mean staying off of it completely.
ICE: Place an ice pack on the injured area for 15-20 minutes every 2-3 hours. A bag of ice wrapped in a thin towel works well. This is usually for the first 24-48 hours after the injury.
COMPRESSION: Compression or an injured wrist, ankle, or knee can help reduce swelling. This is often accomplished by using an elastic wrap (ACE wrap).
ELEVATION: try to keep the injured area above the heart, relative to the ground to minimize the swelling.
Do not apply heat to the area of injury for the first 48 hours. Seek immediate medical treatment. A doctor will evaluate your injury to see if an X-ray of the injured area is needed, and provide treatment and pain relief.
INJURIES IN CHILDREN
How are children’s injuries different than those in adults?
Children are actively growing. The areas in a child’s bone where growth is taking place is called a growth center or a growth plate. These growth centers often are more likely to be injured than surrounding muscles or ligaments. With an injury, in which an adult may sustain a sprain or strain, a child is much more likely to injure a growth center in a bone. A child sustaining an injury that causes pain or swelling should be examined by a physician and may need X-rays. Injury to a bone’s growth center is treated like a fracture with splinting or casting and may take several weeks to heal.
Source: American Academy of Family Physicians, American Academy of Pediatrics, American Medical Society of Sports Medicine, American College of Sports Medicine, and American Orthopedic Society for Sports Medicine, and American Osteopathic Academy of Sports Medicine.
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Seasonal Allergies:
Seasonal allergies affect as many as 40 million Americans. Some are affected only minimally, but some allergies can be life threatening. Most seasonal allergies occur in spring with the new growth of plants, but fall can be a time of allergies also. Some allergies can be year-round (dust mites, animal dander and molds).
WHAT IS AN ALLERGY?
An allergy is an exaggerated reaction to something – in this case, in the environment. Mild allergic reactions include sneezing, itching, watering eyes and rash. More severe reactions include asthma, shortness of breath and collapse of your blood vessels causing shock. It is often hard to tell the difference between allergies and a cold. If you have a fever, it cannot be allergies (hay fever does not cause a fever, despite its nickname). A cold will run its course in 7-10 days, whereas allergies can last for months.
TREATMENT
Mild cases of allergies can be treated with some over-the-counter antihistamines, such as diphenhydramine, loratadine, or chlortrimeton. More severe cases require a doctor’s care. Sometimes your personal physician can take care of this, but for more intense allergies, you may need to see an allergist.
The allergist will probably perform a series of skin and blood tests to determine what you may be allergic to. Once your allergies are determined, the easiest form of treatment is to avoid the substance(s) to which you are allergic.
To avoid the substance which you are allergic to, shut your window and use an air conditioner if you are allergic to plants and trees. Air filters can reduce your exposure to dust, molds and pollens. Install wood, tile or vinyl floors in place of carpet because they can be mopped regularly. If you do keep your carpeting, have someone else do the vacuuming or buy a vacuum with a special filter to reduce dust emissions. Avoid clutter to minimize dust. Keep pets outside or bathe them regularly, if they are indoor pets. Do not let them sleep with you. A mattress cover is helpful to reduce dust mite exposure. In addition, there is a carpet spray, sold under the brand names Allersearch® ADMS Anti-Allergen Dust Mite Spray and DustMiteX® to kill dust mites.
If all of the above steps have not controlled the allergy symptoms, prescription medications may also be used. Most commonly, antihistamines (Allegra® and Zyrtec®, for example) are used first. The next line of medication is a nasal spray. There are 3 categories of nasal sprays: antihistamines (such as Astelin®), steroids (such as Flonase®) and mast cell stabilizers (Nasalcrom®). The nasal medications are used mainly to prevent symptoms, whereas the antihistamines treat symptoms.
For those allergies that do not respond to the above forms of allergy treatments, allergy shots are available.
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WHAT IS AN ALLERGY?
An allergy is an exaggerated reaction to something – in this case, in the environment. Mild allergic reactions include sneezing, itching, watering eyes and rash. More severe reactions include asthma, shortness of breath and collapse of your blood vessels causing shock. It is often hard to tell the difference between allergies and a cold. If you have a fever, it cannot be allergies (hay fever does not cause a fever, despite its nickname). A cold will run its course in 7-10 days, whereas allergies can last for months.
TREATMENT
Mild cases of allergies can be treated with some over-the-counter antihistamines, such as diphenhydramine, loratadine, or chlortrimeton. More severe cases require a doctor’s care. Sometimes your personal physician can take care of this, but for more intense allergies, you may need to see an allergist.
The allergist will probably perform a series of skin and blood tests to determine what you may be allergic to. Once your allergies are determined, the easiest form of treatment is to avoid the substance(s) to which you are allergic.
To avoid the substance which you are allergic to, shut your window and use an air conditioner if you are allergic to plants and trees. Air filters can reduce your exposure to dust, molds and pollens. Install wood, tile or vinyl floors in place of carpet because they can be mopped regularly. If you do keep your carpeting, have someone else do the vacuuming or buy a vacuum with a special filter to reduce dust emissions. Avoid clutter to minimize dust. Keep pets outside or bathe them regularly, if they are indoor pets. Do not let them sleep with you. A mattress cover is helpful to reduce dust mite exposure. In addition, there is a carpet spray, sold under the brand names Allersearch® ADMS Anti-Allergen Dust Mite Spray and DustMiteX® to kill dust mites.
If all of the above steps have not controlled the allergy symptoms, prescription medications may also be used. Most commonly, antihistamines (Allegra® and Zyrtec®, for example) are used first. The next line of medication is a nasal spray. There are 3 categories of nasal sprays: antihistamines (such as Astelin®), steroids (such as Flonase®) and mast cell stabilizers (Nasalcrom®). The nasal medications are used mainly to prevent symptoms, whereas the antihistamines treat symptoms.
For those allergies that do not respond to the above forms of allergy treatments, allergy shots are available.
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Watch Out for Poison Ivy, Sumac and Oak!
Poison Ivy, Poison Sumac and Poison Oak represent a series of rashes called contact dermatitis. These occur when the skin comes into contact with the sap (oils) from one of these plants. This can occur in one of three ways:
WHAT ARE THE SIGNS AND SYMPTOMS OF POISON IVY?
The oils from the sap penetrate the skin very quickly and set up a reaction. The initial response usually occurs 24 - 48 hours after the exposure. The initial signs are severe itching, redness and swelling, followed by blister formation. The rash usually occurs in streaks or lines where the plant came into contact with the skin. The blisters will crust over with time and may take ten days to heal. The fluid from the blister is not contagious. As long as the oils have been washed away, you cannot spread the rash by touching other body parts. The rash may be present in different times on different parts of the body. This is due to different skin thickness on different parts of the body.
Serious problems can occur from excessive swelling, especially the eyes, face, mouth, and genitals. The blisters can also ooze excessive fluid and cause dehydration. This is more likely to occur in infants and young children. The blisters can also become secondarily infected.
WHAT SHOULD YOU DO IF YOU THINK YOU MAY HAVE BEEN EXPOSED?
If you think that you may have been exposed to a poison plant, follow these simple steps:
HOW TO YOU PREVENT GETTING THE RASH?
The easiest way to prevent a poison rash is to be able to identify the causative plants. Poison ivy grows as a vine in the East, Midwest and South. In the North and West it occurs as a shrub. Each leaf is formed from 3 leaflets. Poison oak has 3 - 5 leaflets per leaf. It occurs as either a shrub or vine in the West and as a shrub in the East. Poison sumac has 7 - 13 leaflets per leaf and grows in damp swampy places east of the Mississippi. As a general rule one can think ‘leafs of three beware of me”. If you are trying to rid your backyard of a poison plant, use an herbicide. Burning the plant will only release the oils in the smoke. If you know you are going to be in an area that may have poison ivy, always wear long pants, a long sleeved shirt, boots and gloves. Skin barrier creams such as Bentoquatom (Ivy Block) may be useful if applied prior to exposure. Although pets are not sensitive to poison plants, they can carry the oils on their fur and cause secondary contact to a human. Therefore try to avoid having pets run through areas with poison plants.
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- Direct contact – Touching the sap of one of these plants. This can occur even if the plant is dead.
- Indirect contact – Touching an object that has the sap on it such as animal fur, tools, sports equipment or clothing.
- Airborne exposure – the oils from the plant are released when the plants are burned and may come into contact with you.
WHAT ARE THE SIGNS AND SYMPTOMS OF POISON IVY?
The oils from the sap penetrate the skin very quickly and set up a reaction. The initial response usually occurs 24 - 48 hours after the exposure. The initial signs are severe itching, redness and swelling, followed by blister formation. The rash usually occurs in streaks or lines where the plant came into contact with the skin. The blisters will crust over with time and may take ten days to heal. The fluid from the blister is not contagious. As long as the oils have been washed away, you cannot spread the rash by touching other body parts. The rash may be present in different times on different parts of the body. This is due to different skin thickness on different parts of the body.
Serious problems can occur from excessive swelling, especially the eyes, face, mouth, and genitals. The blisters can also ooze excessive fluid and cause dehydration. This is more likely to occur in infants and young children. The blisters can also become secondarily infected.
WHAT SHOULD YOU DO IF YOU THINK YOU MAY HAVE BEEN EXPOSED?
If you think that you may have been exposed to a poison plant, follow these simple steps:
- Wash all the exposed areas with cold water as soon as possible. Preferably within 5 minutes because the oils penetrate the skin so quickly. Ideally, the entire body should be washed thoroughly with soap and cold water.
- Clothing should be washed or dry cleaned. Any objects that may have come into contact with the oils should also be washed. If you bring clothing into the house, be careful not to allow it to contact carpeting or furniture.
- Relieve the itching of mild rashes by taking a cool shower or by applying cool compresses. Over the counter treatments such as calamine lotion, Epsom salts, or Burrow’s solution may also improve the symptoms. Soaking in a lukewarm bath with oatmeal or baking soda may help dry oozing blisters.
- More severe cases of rash may require treatment by a health professional. Prescription treatments may include steroids, creams or gels. With early treatment, blisters and more severe rash can sometimes be prevented. Unfortunately, over the counter steroid creams are not usually strong enough.
HOW TO YOU PREVENT GETTING THE RASH?
The easiest way to prevent a poison rash is to be able to identify the causative plants. Poison ivy grows as a vine in the East, Midwest and South. In the North and West it occurs as a shrub. Each leaf is formed from 3 leaflets. Poison oak has 3 - 5 leaflets per leaf. It occurs as either a shrub or vine in the West and as a shrub in the East. Poison sumac has 7 - 13 leaflets per leaf and grows in damp swampy places east of the Mississippi. As a general rule one can think ‘leafs of three beware of me”. If you are trying to rid your backyard of a poison plant, use an herbicide. Burning the plant will only release the oils in the smoke. If you know you are going to be in an area that may have poison ivy, always wear long pants, a long sleeved shirt, boots and gloves. Skin barrier creams such as Bentoquatom (Ivy Block) may be useful if applied prior to exposure. Although pets are not sensitive to poison plants, they can carry the oils on their fur and cause secondary contact to a human. Therefore try to avoid having pets run through areas with poison plants.
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What to Do When Insects Sting:
Insect stings can cause a range of reactions from mild localized skin irritation at the sting site to death. The insects responsible for most of the serious human reactions are the yellow jacket, honey bee, wasp and the hornet.
The yellow jacket is the most common venomous stinging insect. These insects nest near humans and scavenge for meats and sweets. Their colonies contain up to 500 bees. They become aggressive when their nests are disturbed and during late summer and autumn when the colony life cycle is ending.
Honey bees live primarily in man-made hives, in large (65,000 bees) colonies where they are used for honey production. They are the world’s most beneficial insect because they cross-pollinate fruits, vegetables and seed crops. They are not aggressive, but will sting if disturbed, leaving the stinger in the victim’s skin.
Paper wasps form small colonies (10 - 25 wasps). They build their nests around buildings. They are not typically as aggressive as bees, yellow jackets and yellow hornets; unless they are disturbed.
Yellow hornets live in colonies of about 1,500. They become aggressive when disturbed by activities such as hedge and shrub trimming.
The insect sting leaves venom in the skin of the victim. This can be poisonous. It may cause an allergic reaction or direct injury to the tissue. The most serious reactions are the allergic reactions. Most of the serious allergic reactions occur within an hour of being stung.
Insect stings in nonallergic people, although painful, usually do not cause serious problems. The problems that can occur may include swelling, muscle breakdown with kidney failure, and infections.
Most stings can be treated at home. Some will require medical attention. Call your doctor or go to an emergency facility if:
Go to an emergency facility immediately if you experience:
Self care at home begins with removing the stinger if it has remained in the skin. This can be done by scraping the stinger with a credit card. Grasping it with tweezers should be used only if necessary as this method can increase the amount of venom you could receive.
Next, apply ice for the pain. Consider taking an antihistamine for itching. Ibuprofen or acetaminophen may help decrease pain. Wash the area of the sting with soap and water and consider using an antibiotic ointment. If it has been more than 5 years since your last tetanus shot, make plans to get one in the next 2 - 3 days.
Prevention is important:
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The yellow jacket is the most common venomous stinging insect. These insects nest near humans and scavenge for meats and sweets. Their colonies contain up to 500 bees. They become aggressive when their nests are disturbed and during late summer and autumn when the colony life cycle is ending.
Honey bees live primarily in man-made hives, in large (65,000 bees) colonies where they are used for honey production. They are the world’s most beneficial insect because they cross-pollinate fruits, vegetables and seed crops. They are not aggressive, but will sting if disturbed, leaving the stinger in the victim’s skin.
Paper wasps form small colonies (10 - 25 wasps). They build their nests around buildings. They are not typically as aggressive as bees, yellow jackets and yellow hornets; unless they are disturbed.
Yellow hornets live in colonies of about 1,500. They become aggressive when disturbed by activities such as hedge and shrub trimming.
The insect sting leaves venom in the skin of the victim. This can be poisonous. It may cause an allergic reaction or direct injury to the tissue. The most serious reactions are the allergic reactions. Most of the serious allergic reactions occur within an hour of being stung.
Insect stings in nonallergic people, although painful, usually do not cause serious problems. The problems that can occur may include swelling, muscle breakdown with kidney failure, and infections.
Most stings can be treated at home. Some will require medical attention. Call your doctor or go to an emergency facility if:
- There is a large local reaction ( greater than 10 inches in diameter)
- There is evidence of an infection
- Any symptoms last more than 2 days
Go to an emergency facility immediately if you experience:
- Difficulty breathing
- Difficulty speaking
- Swelling in the mouth or throat
- Total body rash
- Faintness or lightheadedness
- More than 10 stings
- The eyeball is involved
Self care at home begins with removing the stinger if it has remained in the skin. This can be done by scraping the stinger with a credit card. Grasping it with tweezers should be used only if necessary as this method can increase the amount of venom you could receive.
Next, apply ice for the pain. Consider taking an antihistamine for itching. Ibuprofen or acetaminophen may help decrease pain. Wash the area of the sting with soap and water and consider using an antibiotic ointment. If it has been more than 5 years since your last tetanus shot, make plans to get one in the next 2 - 3 days.
Prevention is important:
- Avoid nests and hives
- Take care when using outdoor motorized equipment, as that may stir up the insects
- If these flying insects are around, don’t swat them and leave the area
- When outdoors, avoid sugary drinks, brightly colored clothing, and strong fragrances, as these attract some insects
- If you have had a strong reaction to a sting in the past, have a self-administered injectable sting kit available, such as an “Epi-pen” and consider wearing a Medic Alert bracelet.
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The contents of this website are for informational purposes only. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or a DocNow Urgent Care Clinic with any questions you may have regarding a medical condition.
