Maybe it’s the crazy weather to blame, but it seems like we’re having a plague of stinging asps, those curious fluffy caterpillars whose poisonous spines and hairs really pack a punch. I thought the explanation from good ol’ Wikipedia was the best I found:
Exposure to the caterpillar's fur-like spines leads to an immediate skin irritation characterized by a, "grid-like hemorrhagic papular eruption with severe radiating pain". The pain has been described by patients as similar to a broken bone or blunt-force trauma.[3] The reactions are sometimes localized to the affected area, but are often very severe, radiating up a limb and causing burning, swelling, nausea, headache, abdominal distress, rashes, blisters, and sometimes chest pain, numbness, or difficulty breathing.[6][7] Additionally, sweating from the welts or hives at the site of the sting is not unusual. https://en.wikipedia.org/wiki/Megalopyge_opercularis
Ouch!! This is definitely consistent with what I have seen in the ER after a sting, especially in children. Children are crying, even screaming with pain, causing me to even provide narcotic analgesics.
Is a visit to the ER always necessary? I’d say probably not actually, as there are a few things to try at home, and the pain typically goes away within an hour. If one of my kiddos were stung, I’d quickly give them a max dose of Motrin (10 mg/kg = 1 tsp for 22 lbs; 2 tsp for 44 lbs; 3 tsp for 66 lbs; 4 tsp for 88 lbs. Teens can have 3 tablets = 600mg); and Benadryl 12.5 mg = 1 tsp liquid for 30-60 pounds and 25 mg = 2 tsp or one tablet for t’weens and teens. Then I’d look for any spines to remove and get an ice pack ready to apply to the area. Finally, I’d comfort and distract them the best I could until the pain subsides. (For my youngest, I’d get his blanket and turn on cartoons; my middle daughter her little dog; my oldest I’d offer him a cash reward for pushing through the pain – you know your child and what will work best!)
I found this great step-by-step approach from the Poison Center Network:
https://www.poison.org/articles/2014-jun/caterpillar-stings
- If the caterpillar is on the skin, remove it without using your hands!
- Gently put tape over the exposed area, sticky side down. (Any kind of tape will do.)
- Pull up the tape, removing the hairs or spines.
- Repeat with fresh pieces of tape as often as needed to treat the area involved.
- Wash the area gently with soap and water.
- If the area itches, put on a paste of baking soda and water.
- If that doesn't help, try a hydrocortisone cream.
- If that doesn't help, try an antihistamine cream. That shouldn’t be the first choice, as it doesn't always help. Also, some people have skin reactions to these creams.
- If the area is badly blistered, contact your health provider.
- Call your health provider about a tetanus booster if your shots are not up to date.
If your child is still inconsolable after all these strategies, definitely come on in! At EliteCare 24 Hr ER, you’ll see me or one of the other physicians shortly after arriving, and we’ll be able to provide stronger medication quickly and make sure that a more serious reaction is not occurring. We at EliteCare hope you have a safe and fun fall!
