Have you been bitten or stung by an insect or spider?
Yes
Insect or spider bite or sting
No
Insect or spider bite or sting
How old are you?
Less than 1 year old
Less than 1 year
1 to 11 years
1 to 11 years
12 years or older
12 years or older
Are you male or female?
- If you are transgender or nonbinary, choose the sex that matches the body parts (such as ovaries, testes, prostate, breasts, penis, or vagina) you now have in the area where you are having symptoms.
- If your symptoms aren’t related to those organs, you can choose the gender you identify with.
- If you have some organs of both sexes, you may need to go through this triage tool twice (once as "male" and once as "female"). This will make sure that the tool asks the right questions for you.
Do you have a concern about a tick bite?
Did the bite or sting involve the eyeball?
Yes
Bite or sting to eyeball
No
Bite or sting to eyeball
This is more likely if you have had a bad reaction to something in the past.
Yes
Possible severe allergic reaction (anaphylaxis)
No
Possible severe allergic reaction (anaphylaxis)
Do you have symptoms of shock?
Have you ever had a
severe allergic reaction to a bite or sting?
A severe allergic reaction affects the whole body. Your doctor may have called it anaphylaxis.
Yes
History of severe allergic reaction to bite or sting
No
History of severe allergic reaction to bite or sting
In the past 2 days, were you exposed to that same allergen, and are you now having symptoms of an allergic reaction?
Even if the symptoms do not start right away or are mild at first, they may quickly become severe.
Yes
History of severe reaction with symptoms now
No
History of severe reaction with symptoms now
Is there any serious swelling?
This could include swelling that is not near the bite or sting area, or swelling that began at the bite or sting site but is expanding well beyond that area. (Some swelling at the site of the bite or sting is normal.)
Yes
New or expanding swelling not near bite or sting
No
New or expanding swelling not near bite or sting
Are the lips, tongue, mouth, or throat swollen?
Yes
Swelling of lips, tongue, mouth, or throat
No
Swelling of lips, tongue, mouth, or throat
Did the lips, tongue, mouth, or throat swell quickly?
Yes
Rapid swelling of lips, tongue, mouth, or throat
No
Rapid swelling of lips, tongue, mouth, or throat
Does swelling involve the palms of the hands, the soles of the feet, or the area from one large joint to another, such as from the ankle to the knee?
Yes
Swelling is across two joints, on soles of feet, or on palms of hands
No
Swelling is across two joints, on soles of feet, or on palms of hands
Is the swelling getting worse (over hours or days)?
Yes
Swelling is getting worse
No
Swelling is getting worse
Did you get an epinephrine shot to treat the reaction?
Yes
Has had epinephrine shot
No
Has had epinephrine shot
Have you been bitten or stung by a poisonous spider (such as a black widow or brown recluse spider), a scorpion, or a caterpillar?
Yes
Bitten or stung by poisonous spider, scorpion, or caterpillar
No
Bitten or stung by poisonous spider, scorpion, or caterpillar
Are there any hives?
Hives are raised, red, itchy patches of skin. They usually have red borders and pale centers. They may seem to move from place to place on the skin.
Do the hives cover many places on your body?
Did the hives appear within 3 hours after the bite or sting?
Yes
Hives developed within 3 hours of bite or sting
No
Hives developed within 3 hours of bite or sting
Yes
Symptoms of infection
Do you think you may have a fever?
Are there red streaks leading away from the area or pus draining from it?
Do you have diabetes, a
weakened immune system, peripheral arterial disease, or any surgical hardware in the area?
"Hardware" includes things like artificial joints, plates or screws, catheters, and medicine pumps.
Yes
Diabetes, immune problems, peripheral arterial disease, or surgical hardware in affected area
No
Diabetes, immune problems, peripheral arterial disease, or surgical hardware in affected area
Have you developed any flu-like symptoms after the bite or sting, such as fever, shaking chills, muscle or joint pain, headache, or a general feeling of illness?
This could happen within minutes of the bite or sting or up to 3 weeks later.
Did these symptoms begin within minutes after the bite or sting?
Yes
Flu-like symptoms began within minutes after bite or sting
No
Flu-like symptoms began within minutes after bite or sting
Do you have other symptoms, such as belly pain, vomiting, or diarrhea?
Yes
Has other symptoms, such as belly pain, vomiting, or diarrhea
No
Has other symptoms, such as belly pain, vomiting, or diarrhea
Did these symptoms begin within minutes after the bite or sting?
Yes
Other symptoms began within minutes after bite or sting
No
Other symptoms began within minutes after bite or sting
Yes
Sudden appearance of red or purple spots or bruising
No
Sudden appearance of red or purple spots or bruising
Is there a blister, a painful sore, or a purple discoloration at the site of a bite or sting?
Yes
Blister, painful sore, or purple discoloration at bite or sting site
No
Blister, painful sore, or purple discoloration at bite or sting site
Are you having new muscle spasms or stiffness?
Yes
Muscle spasms or stiffness after bite or sting
No
Muscle spasms or stiffness after bite or sting
Do you have pain at the site of the bite or sting?
The pain may feel like a burning pain. It may be very bad for several minutes right after the bite. You may still have some pain hours later.
Yes
Pain or burning pain at site of bite or sting
No
Pain or burning pain at site of bite or sting
How bad is the pain on a scale of 0 to 10, if 0 is no pain and 10 is the worst pain you can imagine?
8 to 10: Severe pain
Severe pain
5 to 7: Moderate pain
Moderate pain
1 to 4: Mild pain
Mild pain
Has the pain lasted for more than 8 hours?
Yes
Pain for more than 8 hours
No
Pain for more than 8 hours
Is the pain getting worse?
Yes
Pain is getting worse
Have you tried home treatment for more than 2 days?
Home treatment includes things like using ice on the area, taking an antihistamine, and taking pain medicine such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin).
Yes
Home treatment for more than 2 days
No
Home treatment for more than 2 days
Did you get more than one bite or sting?
This does not include mosquito bites.
Yes
More than 1 bite or sting
No
More than 1 bite or sting
Was there more than one bite or sting from bees, wasps, hornets, yellow jackets, or fire ants?
Yes
2 or more bites or stings from bees, wasps, hornets, yellow jackets, or fire ants
No
2 or more bites or stings from bees, wasps, hornets, yellow jackets, or fire ants
Did you get at least 5 bites or stings from bees, wasps, hornets, yellow jackets, or fire ants?
Yes
5 or more bites or stings from bees, wasps, hornets, yellow jackets, or fire ants
No
5 or more bites or stings from bees, wasps, hornets, yellow jackets, or fire ants
Did you get at least 10 bites or stings from bees, wasps, hornets, yellow jackets, or fire ants?
Yes
10 or more bites or stings from bees, wasps, hornets, yellow jackets, or fire ants
No
10 or more bites or stings from bees, wasps, hornets, yellow jackets, or fire ants
Do you think you may need a
tetanus shot?
Yes
May need tetanus shot
Have symptoms lasted for more than a week after the bite or sting?
Yes
Symptoms for more than 1 week after bite or sting
No
Symptoms for more than 1 week after bite or sting
Many things can affect how your body responds to a symptom and what kind of care you may need. These include:
- Your age. Babies and older adults tend to get sicker quicker.
- Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
- Medicines you take. Certain medicines, such as blood thinners (anticoagulants), medicines that suppress the immune system like steroids or chemotherapy, herbal remedies, or supplements can cause symptoms or make them worse.
- Recent health events, such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.
- Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.
Try Home Treatment
You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.
- Try home treatment to relieve the symptoms.
- Call your doctor if symptoms get worse or you have any concerns (for example, if symptoms are not getting better as you would expect). You may need care sooner.
Symptoms of a severe allergic reaction (anaphylaxis) may include:
- The sudden appearance of raised, red areas (hives) all over the body.
- Rapid swelling of the throat, mouth, or tongue.
- Trouble breathing.
- Passing out (losing consciousness). Or you may feel very lightheaded or suddenly feel weak, confused, or restless.
- Severe belly pain, nausea, vomiting, or diarrhea.
A severe reaction can be life-threatening. If you have had a bad allergic reaction to a substance before and are exposed to it again, treat any symptoms as an emergency. Even if the symptoms are mild at first, they may quickly become very severe.
Symptoms of infection may include:
- Increased pain, swelling, warmth, or redness in or around the area.
- Red streaks leading from the area.
- Pus draining from the area.
- A fever.
Pain in adults and older children
- Severe pain (8 to 10): The pain is so bad that you can't stand it for more than a few hours, can't sleep, and can't do anything else except focus on the pain.
- Moderate pain (5 to 7): The pain is bad enough to disrupt your normal activities and your sleep, but you can tolerate it for hours or days. Moderate can also mean pain that comes and goes even if it's severe when it's there.
- Mild pain (1 to 4): You notice the pain, but it is not bad enough to disrupt your sleep or activities.
Pain in children under 3 years
It can be hard to tell how much pain a baby or toddler is in.
- Severe pain (8 to 10): The pain is so bad that the baby cannot sleep, cannot get comfortable, and cries constantly no matter what you do. The baby may kick, make fists, or grimace.
- Moderate pain (5 to 7): The baby is very fussy, clings to you a lot, and may have trouble sleeping but responds when you try to comfort him or her.
- Mild pain (1 to 4): The baby is a little fussy and clings to you a little but responds when you try to comfort him or her.
Certain health conditions and medicines weaken the immune system's ability to fight off infection and illness. Some examples in adults are:
- Diseases such as diabetes, cancer, heart disease, and HIV/AIDS.
- Long-term alcohol and drug problems.
- Steroid medicines, which may be used to treat a variety of conditions.
- Chemotherapy and radiation therapy for cancer.
- Other medicines used to treat autoimmune disease.
- Medicines taken after organ transplant.
- Not having a spleen.
Shock is a life-threatening condition that may quickly occur after a sudden illness or injury.
Adults and older children often have several symptoms of shock. These include:
- Passing out (losing consciousness).
- Feeling very dizzy or lightheaded, like you may pass out.
- Feeling very weak or having trouble standing.
- Not feeling alert or able to think clearly. You may be confused, restless, fearful, or unable to respond to questions.
Shock is a life-threatening condition that may occur quickly after a sudden illness or injury.
Babies and young children often have several symptoms of shock. These include:
- Passing out (losing consciousness).
- Being very sleepy or hard to wake up.
- Not responding when being touched or talked to.
- Breathing much faster than usual.
- Acting confused. The child may not know where he or she is.
Usually found in dirt and soil, tetanus bacteria typically enter the body through a wound. Wounds may include a bite, a cut, a puncture, a burn, a scrape, insect bites, or any injury that may cause broken skin. Tetanus can also happen with other infections, like dental infections. It can happen during a surgery or pregnancy and delivery.
A wound can be so small, you may not notice you have one. Or a skin blister could break and become an open wound. If there is any delay in finding or cleaning a wound, there is an increased risk for skin infection and a chance for tetanus to get in the wound. A tetanus infection can start 3 to 21 days after the bacteria enter the wound. Be especially careful about wounds on your fingers and toes.
Many people may not know when they got their last tetanus shot. So it's a good idea to call your doctor to see if you need one.
Make sure to stay up to date on your tetanus shots. A tetanus shot is recommended:
- For a dirty wound that has things like dirt, saliva, or feces in it, if you haven't had a tetanus shot in the past 5 years.
- For a clean wound, if you haven't had a tetanus shot in the past 10 years.
Sudden tiny red or purple spots or sudden bruising may be early symptoms of a serious illness or bleeding problem. There are two types.
Petechiae (say "puh-TEE-kee-eye"):
- Are tiny, flat red or purple spots in the skin or the lining of the mouth.
- Do not turn white when you press on them.
- Range from the size of a pinpoint to the size of a small pea and do not itch or cause pain.
- May spread over a large area of the body within a few hours.
- Are different than tiny, flat red spots or birthmarks that are present all the time.
Purpura (say "PURR-pyuh-ruh" or "PURR-puh-ruh"):
- Is sudden, severe bruising that occurs for no clear reason.
- May be in one area or all over.
- Is different than the bruising that happens after you bump into something.
Seek Care Now
Based on your answers, you may need care right away. The problem is likely to get worse without medical care.
- Call your doctor now to discuss the symptoms and arrange for care.
- If you cannot reach your doctor or you don't have one, seek care in the next hour.
- You do not need to call an ambulance unless:
- You cannot travel safely either by driving yourself or by having someone else drive you.
- You are in an area where heavy traffic or other problems may slow you down.
Call 911 Now
Based on your answers, you need emergency care.
Call 911 or other emergency services now.
Sometimes people don't want to call 911. They may think that their symptoms aren't serious or that they can just get someone else to drive them. Or they might be concerned about the cost. But based on your answers, the safest and quickest way for you to get the care you need is to call 911 for medical transport to the hospital.
Seek Care Today
Based on your answers, you may need care soon. The problem probably will not get better without medical care.
- Call your doctor today to discuss the symptoms and arrange for care.
- If you cannot reach your doctor or you don't have one, seek care today.
- If it is evening, watch the symptoms and seek care in the morning.
- If the symptoms get worse, seek care sooner.
Make an Appointment
Based on your answers, the problem may not improve without medical care.
- Make an appointment to see your doctor in the next 1 to 2 weeks.
- If appropriate, try home treatment while you are waiting for the appointment.
- If symptoms get worse or you have any concerns, call your doctor. You may need care sooner.
Seek Care Now
Based on your answers, you may need care right away. The problem is likely to get worse without medical care.
- Call your doctor now to discuss the symptoms and arrange for care.
- If you cannot reach your doctor or you don't have one, go to the emergency room now. You may have a reaction after the epinephrine wears off.
- You do not need to call an ambulance unless:
- You cannot travel safely either by driving yourself or by having someone else drive you.
- You are in an area where heavy traffic or other problems may slow you down.
Eye Injuries
Tick Bites