How is a bee sting allergy diagnosed. What are the emergency treatments for severe allergic reactions to bee stings. How can you manage minor bee sting reactions at home. What role does prednisone play in treating bee stings.

Diagnosing Bee Sting Allergies: Tests and Procedures

Accurately diagnosing a bee sting allergy is crucial for proper treatment and prevention of potentially life-threatening reactions. Healthcare providers typically employ two main diagnostic methods:

Skin Test for Bee Venom Allergy

A skin test involves injecting a small amount of bee venom extract into the skin of the arm or upper back. This procedure is generally safe and doesn’t cause severe reactions. If an allergy is present, a raised bump will develop at the test site within a short period.

Allergy Blood Test

Blood tests measure the immune system’s response to bee venom by quantifying allergy-causing antibodies in the bloodstream. A sample is sent to a laboratory for analysis, providing evidence of sensitivity to potential allergens.

Often, healthcare providers use both skin tests and blood tests in conjunction to ensure a comprehensive diagnosis. Additionally, they may test for allergies to other stinging insects like yellow jackets, hornets, and wasps, as these can cause similar allergic reactions.

Emergency Treatment for Severe Allergic Reactions to Bee Stings

Anaphylaxis, a severe allergic reaction to bee stings, requires immediate medical attention. Emergency medical teams may need to perform cardiopulmonary resuscitation (CPR) if breathing or heartbeat stops. The following medications may be administered:

• Epinephrine (adrenaline) to reduce the body’s allergic response
• Oxygen to assist breathing
• Intravenous (IV) antihistamines and cortisone to reduce airway inflammation
• Beta agonists (e.g., albuterol) to relieve respiratory symptoms

Epinephrine Autoinjectors: A Lifesaving Tool

For individuals with known bee sting allergies, doctors often prescribe emergency epinephrine autoinjectors (e.g., EpiPen, Auvi-Q). These devices combine a syringe and concealed needle to deliver a single dose of epinephrine when pressed against the thigh. It’s crucial to always carry the autoinjector and ensure it hasn’t expired.

Is proper training necessary for using an epinephrine autoinjector? Absolutely. Both the allergic individual and those close to them should be familiar with the device’s operation, as it could be life-saving in an emergency. Consider wearing a medical alert bracelet to inform others of your bee sting allergy.

The Role of Prednisone in Treating Bee Stings

While not mentioned in the original text, prednisone, a corticosteroid medication, can play a significant role in managing bee sting reactions, particularly for more severe cases or those with delayed symptoms.

How Does Prednisone Work for Bee Stings?

Prednisone works by suppressing the immune system’s response to the bee venom, thereby reducing inflammation, swelling, and other allergic symptoms. It’s particularly effective for large local reactions or systemic reactions that aren’t immediately life-threatening.

When Is Prednisone Prescribed for Bee Stings?

Healthcare providers may prescribe prednisone in the following scenarios:

• For large local reactions that persist or worsen over time
• As part of a treatment plan for individuals with known bee sting allergies
• To prevent delayed anaphylactic reactions in some cases
• To manage symptoms after initial emergency treatment for severe reactions

Can prednisone replace epinephrine in emergency situations? No, prednisone is not a substitute for epinephrine in cases of anaphylaxis. Epinephrine remains the first-line treatment for severe allergic reactions due to its rapid action.

Allergy Shots: Long-Term Management of Bee Sting Allergies

For individuals who have experienced serious reactions to bee stings or multiple stings, allergists may recommend allergy shots, also known as immunotherapy. This long-term treatment approach aims to reduce or eliminate the allergic response to bee venom.

How Do Allergy Shots Work?

Allergy shots involve regular injections of gradually increasing doses of bee venom over several years. This controlled exposure helps the immune system become less sensitive to the allergen, potentially preventing severe reactions in the future.

Effectiveness and Duration of Immunotherapy

While the duration of treatment can vary, most individuals undergo allergy shots for 3-5 years. The effectiveness of immunotherapy can be significant, with many patients experiencing a substantial reduction in their allergic response to bee stings.

Are allergy shots suitable for everyone with bee sting allergies? Not necessarily. The decision to undergo immunotherapy should be made in consultation with an allergist, considering factors such as the severity of past reactions, overall health, and commitment to long-term treatment.

Home Remedies and Lifestyle Management for Minor Bee Stings

For ordinary bee stings that don’t trigger an allergic reaction, home treatment is often sufficient. Here are some steps to manage minor bee sting reactions:

1. Remove the stinger promptly, if present, by scraping it off with a fingernail.
2. Wash the affected area thoroughly with soap and water.
3. Apply a cold compress to reduce swelling and pain.
4. Take an over-the-counter pain reliever if needed.
5. Elevate the affected limb if the sting is on an arm or leg.
6. Apply hydrocortisone cream or calamine lotion to alleviate itching and swelling.
7. Consider taking an oral antihistamine for additional relief.

Is it necessary to remove the stinger immediately? Yes, quick removal of the stinger can help minimize the amount of venom injected, potentially reducing the severity of the reaction.

Managing Moderate Reactions

For larger local reactions that cause more significant swelling and discomfort, additional steps may be helpful:

• Take an oral antihistamine containing diphenhydramine or chlorpheniramine.
• Apply hydrocortisone cream or calamine lotion more frequently.
• Keep the affected area elevated to reduce swelling.
• Avoid scratching to prevent infection and increased itching.

Prevention Strategies: Minimizing the Risk of Bee Stings

While it’s impossible to completely eliminate the risk of bee stings, there are several strategies individuals can employ to minimize their chances of being stung:

Protective Clothing and Behavior

When spending time outdoors, especially in areas where bees are likely to be present, consider the following precautions:

• Wear light-colored, smooth-finished clothing
• Avoid loose-fitting garments that can trap bees
• Wear closed-toe shoes and avoid walking barefoot in grassy areas
• Avoid wearing strong perfumes or scented products that may attract bees
• Be cautious around flowering plants, garbage cans, and picnic areas

Proper Landscaping and Home Maintenance

To reduce the likelihood of bee encounters around your home:

• Keep your yard free of flowering weeds like dandelions
• Avoid planting flowers close to your home’s entrance
• Seal cracks and crevices in walls and roofs where bees might nest
• Cover garbage cans and compost bins to avoid attracting bees

Can certain colors attract bees more than others? Yes, bees are generally more attracted to bright colors, particularly blue, purple, and yellow. Opting for muted or light colors when outdoors can help reduce your visibility to bees.

Understanding Different Types of Stinging Insects

While bee stings are common, it’s important to recognize that other insects can cause similar reactions. Understanding the differences can help in proper identification and treatment:

Bees vs. Wasps and Hornets

Bees, wasps, and hornets all belong to the order Hymenoptera but have distinct characteristics:

• Bees: Generally furry with rounded bodies; most species can only sting once
• Wasps: Smooth, slender bodies; can sting multiple times
• Hornets: Larger than wasps with chunkier bodies; also capable of multiple stings

Identifying Sting Characteristics

The type of reaction and sting appearance can provide clues about the insect responsible:

• Bee stings often leave the stinger behind in the skin
• Wasp and hornet stings typically don’t leave a stinger
• Fire ant stings usually result in a pustule formation

Does the type of stinging insect affect treatment approaches? While initial treatment for most stings is similar, knowing the specific insect can be crucial for allergic individuals and in determining the risk of multiple stings.

When to Seek Medical Attention for Bee Stings

While most bee stings can be managed at home, certain situations require immediate medical attention. Being aware of these scenarios can be life-saving:

Signs of a Severe Allergic Reaction

Seek emergency care if you experience any of the following after a bee sting:

• Difficulty breathing or wheezing
• Swelling of the throat or tongue
• Dizziness or fainting
• Rapid or weak pulse
• Nausea, vomiting, or diarrhea
• Hives or severe itching in areas other than the sting site

Other Situations Requiring Medical Evaluation

Consider seeking medical attention in these cases:

• Multiple stings, especially in children, older adults, or those with health conditions
• Stings inside the mouth or throat
• Large local reactions that continue to worsen after 48 hours
• Signs of infection, such as increasing pain, redness, or swelling after a few days

How quickly can anaphylaxis develop after a bee sting? Severe allergic reactions typically occur within minutes to a few hours after the sting, emphasizing the importance of prompt recognition and treatment.

The Future of Bee Sting Treatment: Emerging Research and Therapies

While current treatments for bee stings are effective, ongoing research aims to improve both prevention and management strategies:

Advancements in Immunotherapy

Researchers are exploring new approaches to make immunotherapy more effective and convenient:

• Sublingual immunotherapy: Administering small doses of allergen under the tongue
• Accelerated immunotherapy protocols: Achieving desensitization more quickly
• Molecular-based therapies targeting specific components of bee venom

Novel Treatments on the Horizon

Emerging areas of research include:

• Development of more potent and longer-lasting epinephrine formulations
• Exploration of biological therapies to modulate the immune response
• Investigation of gene therapies to prevent severe allergic reactions

Could future treatments eliminate the need for lifelong management of bee sting allergies? While it’s an ambitious goal, ongoing research offers hope for more effective and potentially curative treatments in the future.

As research progresses, individuals with bee sting allergies should stay informed about new developments and consult with their healthcare providers about the most appropriate and up-to-date treatment options for their specific situations.

Bee sting – Diagnosis and treatment

Diagnosis

If you’ve had a reaction to bee stings that suggests you might be allergic to bee venom, your doctor may suggest one or both of the following tests:

• Skin test. During skin testing, a small amount of allergen extract (in this case, bee venom) is injected into the skin of your arm or upper back. This test is safe and won’t cause any serious reactions. If you’re allergic to bee stings, you’ll develop a raised bump on your skin at the test site.
• Allergy blood test. A blood test can measure your immune system’s response to bee venom by measuring the amount of allergy-causing antibodies in your bloodstream. A blood sample is sent to a medical laboratory, where it can be tested for evidence of sensitivity to possible allergens.

Allergy skin tests and allergy blood tests are often used together to diagnose insect allergies. Your doctor may also want to test you for allergies to yellow jackets, hornets and wasps — which can cause allergic reactions similar to those of bee stings.

Treatment

For ordinary bee stings that do not cause an allergic reaction, home treatment is enough. Multiple stings or an allergic reaction, on the other hand, can be a medical emergency that requires immediate treatment.

Emergency treatment for allergic reactions

During an anaphylactic attack, an emergency medical team may perform cardiopulmonary resuscitation (CPR) if you stop breathing or your heart stops beating. You may be given medications including:

• Epinephrine (adrenaline) to reduce your body’s allergic response
• Oxygen, to help you breathe
• Intravenous (IV) antihistamines and cortisone to reduce inflammation of your air passages and improve breathing
• A beta agonist (such as albuterol) to relieve breathing symptoms

Epinephrine autoinjector

If you’re allergic to bee stings, your doctor is likely to prescribe an emergency epinephrine autoinjector (EpiPen, Auvi-Q, others). You’ll need to have it with you at all times. An autoinjector is a combined syringe and concealed needle that injects a single dose of medication when pressed against your thigh. Always be sure to replace epinephrine by its expiration date.

Be sure you know how to use the autoinjector. Also, make sure the people closest to you know how to administer the drug — if they’re with you in an anaphylactic emergency, they could save your life. Medical personnel called in to respond to a severe anaphylactic reaction also may give you an epinephrine injection or another medication.

Consider wearing an alert bracelet that identifies your allergy to bee or other insect stings.

Allergy shots

Bee and other insect stings are a common cause of anaphylaxis. If you’ve had a serious reaction to a bee sting or multiple stings, your doctor likely will refer you to an allergist for allergy testing and consideration of allergy shots (immunotherapy). These shots, generally given regularly for a few years, can reduce or eliminate your allergic response to bee venom.

Lifestyle and home remedies

If a bee stings you or your child, follow the suggestions below.

Treatment for minor reactions

• If you can, remove the stinger as soon as possible, such as by scraping it off with a fingernail. Don’t try to remove a stinger below the skin surface. A stinger may not be present, as only bees leave their stingers. Other stinging insects, such as wasps, do not.
• Wash the sting area with soap and water.
• Apply a cold compress.

Treatment for moderate reactions

The following steps may help ease the swelling and itching often associated with large local reactions:

• If you can, remove the stinger as soon as possible, such as by scraping it off with a fingernail. Don’t try to remove a stinger below the skin surface. A stinger may not be present, as only bees leave their stingers. Other stinging insects, such as wasps, do not.
• Wash the affected area with soap and water.
• Apply a cold compress.
• Take an over-the-counter pain reliever as needed. You might try ibuprofen (Advil, Motrin IB, others) to help ease discomfort.
• If the sting is on an arm or leg, elevate it.
• Apply hydrocortisone cream or calamine lotion to ease redness, itching or swelling.
• If itching or swelling is bothersome, take an oral antihistamine that contains diphenhydramine (Benadryl) or chlorpheniramine.
• Avoid scratching the sting area. This will worsen itching and swelling and increase your risk of infection.

Preparing for your appointment

Bee and other insect stings are a common cause of anaphylaxis. If you’ve had a serious reaction to a bee sting but did not seek emergency treatment, consult your doctor. He or she may refer you to an allergy specialist (allergist) who can determine whether you’re allergic to bee or other insect venom and can help you find ways to prevent future allergic reactions.

Your doctor or allergist will do a thorough physical examination and will want to know:

• When and where you were stung
• What symptoms you had after getting stung
• Whether you’ve had an allergic reaction to an insect sting in the past, even if it was minor
• Whether you have other allergies, such as hay fever
• What medications you take, including herbal remedies
• Any health problems you have

Some questions you might want to ask your doctor include:

• What do I do if I get stung again?
• If I have an allergic reaction, do I need to use emergency medication such as an epinephrine autoinjector (EpiPen, Auvi-Q, others)?
• How can I prevent this reaction from happening again?

Don’t hesitate to ask other questions, as well.

Aug. 06, 2020

Antihistamines, Corticosteroids, Sympathomimetics, Histamine h3 Antagonists, Vasopressors, Alpha/Beta Adrenergic Agonists, Glucose-Elevating Agents

Author

Carl A Mealie, MD, FACEP, FAAEM Assistant Professor, Department of Emergency Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell; Chief of Operations, Department of Emergency Medicine, Long Island Jewish Medical Center

Carl A Mealie, MD, FACEP, FAAEM is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, American College of Physicians, American Medical Association, New York Academy of Medicine, Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Coauthor(s)

Max Vernon Wisgerhof, II, MD Fellowship Program Director, Department of Endocrinology and Metabolism, Henry Ford Hospital

Max Vernon Wisgerhof, II, MD is a member of the following medical societies: American Thyroid Association, Endocrine Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Chief Editor

Joe Alcock, MD, MS Associate Professor, Department of Emergency Medicine, University of New Mexico Health Sciences Center

Joe Alcock, MD, MS is a member of the following medical societies: American Academy of Emergency Medicine

Disclosure: Nothing to disclose.

Additional Contributors

Lisa Kirkland, MD, FACP, FCCM, MSHA Assistant Professor, Department of Internal Medicine, Division of Hospital Medicine, Mayo Clinic; Chair, Department of Critical Care, ANW Intensivists, Abbott Northwestern Hospital

Lisa Kirkland, MD, FACP, FCCM, MSHA is a member of the following medical societies: American College of Physicians, Society of Critical Care Medicine, Society of Hospital Medicine

Disclosure: Nothing to disclose.

Acknowledgements

Alan S Multz, MD Associate Professor of Clinical Medicine, Albert Einstein College of Medicine; Program Director, Internal Medicine Residency, Associate Chairman, Department of Medicine, Long Island Jewish Medical Center

Alan S Multz, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Chest Physicians, American College of Physicians, American Thoracic Society, and Society of Critical Care Medicine

Disclosure: Astellas Pharmaceutical Honoraria Consulting; Merck Pharmaceutical Honoraria Speaking and teaching; The Medicines Company Honoraria Consulting; Schering Plough Honoraria Speaking and teaching; Wyeth Pharmaceuticals Honoraria Speaking and teaching; Pfizer Honoraria Speaking and teaching

Treatment of insect bites

Insect bites usually cause mild irritations and can be managed safely at home. The bites and stings lead to small localized reactions that remain confined to the area around the bite or sting. However, large localized reactions or generalized allergic reactions need to be seen and treated by physicians. 1-5

The first step is to move to a safer area to avoid more stings or bites.

Removal of an insect sting

When visible a bee or wasp sting may be removed carefully. Bees usually leave the sting behind but a wasp or hornet may not leave the sting behind and may sting again. If attacked by a wasp or hornet one should walk away calmly to avoid being stung again.

Care should be taken not to rupture the venom sac within the sting that results in spread of the venom and severe pain and allergic reaction. The sting can be removed by scraping it out with long finger nails or with a hard edged card.

The sting should not be squeezed of held with tweezers as it may rupture the venom sac and release the venom into the skin. If a child has been stung, an adult should remove the sting.

Basic home measures to treat insect bites and stings

Minor bites and stings with localized reactions may be treated with basic home measures. The local area should be washed with soap and water to remove the allergenic saliva. Thereafter a cold compress may be placed over the area to ease the pain and swelling.

The bitten child or person is advised not to scratch as this may lead to infections. The fingernails should be kept clean and short and filed to avoid skin injury.

Avoiding infections from insect bites

Blisters and bullae should not be burst as these may develop infections and open sores. An adhesive bandage or plaster may be used to protect the area.

Treating infected insect bites

If the bites are infected antibiotics may be prescribed. Severe infections may need antibiotic pills prescribed by a doctor.

Relieving pain caused by insect bites

For painful stings an ice pack may be applied. Pain relievers like Paracetamol, Ibuprofen etc. may be taken for the pain and inflammation. Some over the counter sprays or creams with antihistaminics (reduce the allergic reaction), local anesthetic (numbs the area) or steroid (hydrocortisone 1% for inflammation) may be used to prevent itching and swelling.

Crotamiton ointment (available at pharmacies), calamine lotion, or a baking soda paste are soothing as well. Antihistaminic or allergy reducing tablets may be taken to reduce the allergic reactions.

Treatment for a large localized reaction

Those with a large localized reaction may require a prescription of a short course of steroids like prednisolone pills to be taken for three to five days. Those with severe generalized reactions like anaphylaxis may need adrenaline injections, oxygen and fluids.

Treatment for severe allergic reactions

Those with a severe allergic reaction that extends with a redness and swelling of over 10cm (4 inches) in diameter may need evaluation at an allergy clinic. These patients may be advised Immunotherapy (desensitisation or hyposensitisation) to reduce their risks of developing an allergy to the sting.

Treating ticks

The tick usually clings to the skin. Ticks are removed using tweezers after wearing gloves to avoid exposure of the fingers to the tick. The tick should be removed as a whole and while removing care should be taken not to break it off so as to leave behind the mouthparts of the tick within the skin.

If this does not work petroleum jelly, alcohol or a lit match may be used to remove the tick.

After removal hands should be washed with soap and water and the area should be washed with soap and water or an antiseptic. Those with a rash or fever may have acquired Lyme disease that are carried by ticks and may need evaluation and treatment.

Further Reading

Take the Sting Out of Bee Stings!

Bees and I do not get along.  A playmate in my first grade class in Corvallis, Oregon stumbled upon a yellow jacket nest, so one of my earliest memories is standing in a classroom of screaming children while bees swarmed the room.   While pregnant with my first child and taking the Internal Medicine Board Examination, a bee stung my upper lip from a juice can.  Because of the pregnancy, I could not take many medicines.  After a week of hearing scratching noises in our ceiling when first moving to our house, my husband and I awoke to have hundreds of bees everywhere since they chewed through the wood from the attic.  It was like a scene from a horror movie.  These personal experiences, as well as treating patients with bee stings has made me wary when I see wasps or bees hovering at a picnic or outside event.

Thankfully I have never suffered from anaphylaxis to bee stings.   Anaphylaxis is defined as a serious allergic reaction with symptoms of throat swelling, facial swelling, shortness of breath, drop in blood pressure, loss of consciousness, nausea and vomiting.  In the U.S., at least 40 deaths per year are reported from anaphylaxis due to bee or wasp stings.[i]  If you have these symptoms due to a bee sting, call 911 and go directly to the nearest emergency department.   If you have an auto injector with epinephrine, use that immediately.  Once epinephrine is administered, the emergency department also gives antihistamines such as Benadryl, oxygen and inhalers such as Albuterol (which open up the airways).[ii]  Antihistamines block histamine, which is a substance that is responsible for many of the symptoms of allergies.  Commonly used non-sedating antihistamines go by the brand names Claritin, Allegra and Zyrtec.  Often corticosteroids such as prednisone are given to decrease inflammation, local skin reaction to the sting and theoretically prevent a possible recurrence of symptoms (biphasic reaction) hours later. 

Anyone who develops anaphylaxis to bee stings should see an allergist for skin testing and evaluation for allergy shots.  These types of shots are called immunotherapy and can lower the risk of anaphylaxis to less than 5% and also decrease the allergic reaction in general.  Generally these shots should be given for 5 years as studies show better efficacy after this time frame.  

Most people do not suffer anaphylactic shock after a bee sting.  Local reactions are much more common.  Usual treatment includes cold compresses/ice, antihistamines , such as Benadryl or Zyrtec and topical steroids such as hydrocortisone.  Oral steroids such as prednisone can help patients who have significant swelling at the site of the sting. 

The mainstay of prevention is to avoid getting stung.  Wear long sleeves and long pants when gardening and be aware of your surroundings so as not to stumble into a yellow jacket nest as my classmate did in first grade.  If you have severe reactions to bees, always carry injectable epinephrine (also called Epipen, AuviQ and Adrenaclick) with you to treat anaphylaxis.   If stung, immediately remove the stinger with a blunt edge such as a credit card, apply ice and take an antihistamine.  If there are any signs of anaphylaxis such as throat closing or swelling, immediately inject with epinephrine and call 911 to go to the nearest emergency department to get more advanced care.

This summer, stay healthy by avoiding wasps and bees and be prepared to treat stings.  Enjoy the great outdoors and the honey that they make, but be cautious when you see those yellow and black flying insects!

[i] Casale, T.B. and Burks, A.W.  Hymenoptera-Sting Hypersensitivity  New England Journal of Medicine, 2014; 370:1432-9.

[ii] http://www.aafp.org/afp/2003/0615/p2541.html

Other references:

http://www.aaaai.org/conditions-and-treatments/library/allergy-library/stinging-insect-allergy.aspx\

http://www.hopkinsmedicine.org/healthlibrary/conditions/non-traumatic_emergencies/bee_stings_85,P00817/

Prednisone: uses & side-effects | PatientsLikeMe

Prednisone: uses & side-effects | PatientsLikeMe

Feb 23, 2021
(Started Jun 09, 2020)

• Effectiveness

  Moderate
  (for arthritis pain in knees)

• Side effects

  Mild
  (increased appetite, headaches, insomnia)

• Burden

  A little hard to take

Dosage:
10 mg
Four times daily

Jun 11, 2020
(Started Jun 09, 2020)

• Effectiveness

  Major
  (for arthritis pain in knees)

• Side effects

  Moderate
  (increased appetite, headaches, insomnia)

• Burden

  A little hard to take

Dosage:
10 mg
Four times daily

Advice & Tips:
The dosage changes every few days, tapering from 40 mg qd to 10 mg qd. I have it written in my calendar and I check off each day as I finish it.

Cost:
< $25 monthly

Nov 17, 2018
(Started Oct 15, 2018)

• Effectiveness

  Major
  (for Bell’s palsy)

• Effectiveness

  Major
  (for difficulty eating)

• Effectiveness

  Major
  (for facial pain)

• Effectiveness

  Major
  (for facial paralysis)

• Effectiveness

  Major
  (for nerve pain (neuralgia))

• Side effects

  Mild
  (bad taste in mouth)

• Burden

  Not at all hard to take

Dosage:
5 mg
Daily

Cost:
< $25 monthly

Oct 24, 2018
(Started Oct 15, 2018)

• Effectiveness

  Slight
  (for Bell’s palsy)

• Effectiveness

  Major
  (for facial pain)

• Effectiveness

  Slight
  (for facial paralysis)

• Side effects

  Moderate
  (bad taste in mouth)

• Burden

  Not at all hard to take

Dosage:
5 mg
Daily

Cost:
< $25 monthly

Aug 24, 2017
(Started Dec 15, 2015)

• Effectiveness

  Can’t tell
  (for bronchospasm)

• Effectiveness

  Can’t tell
  (for asthma)

• Effectiveness

  Can’t tell
  (for influenza (the “flu”))

• Effectiveness

  Can’t tell
  (for pneumonia)

• Side effects

  Mild
  (fluid retention (edema))

• Burden

  Not at all hard to take

Dosage:

As needed

Advice & Tips:
Currently I just take 20 mg the day before and after my IVIG. I receive 40 mg the day of the infusion as premedication.

Dec 19, 2015
(Started Dec 15, 2015)

• Effectiveness

  Moderate
  (for pneumonia)

• Side effects

  Mild
  (fluid retention (edema))

• Burden

  Not at all hard to take

Dosage:
20 mg
Daily

Bee Stings and Venom Allergies

Bee stings are painful for everyone, but for some people — those with venom allergies — stings carry a special risk of a severe allergic reaction.

What should you do if your child is stung, and how can you tell if your child has a venom allergy? Joel Fiedler, MD, an attending physician with the Allergy Program at Children’s Hospital of Philadelphia (CHOP), offers some practical guidance.

What to watch for if your child is stung by a bee

First, Dr. Fiedler explains that what we commonly refer to as “bee stings” include, for allergists, stings by honey bees, bumblebees, yellow jackets, wasps and hornets. These insects are not all bees, but they inject similar venom into the body when they sting. Fire ants can also deliver venomous stings.

“When most people are stung by an insect, they develop local swelling in the area of the sting,” says Dr. Fiedler. This can be painful, and the swelling can sometimes be dramatic — extending along the entire upper arm, for example. But if the swelling is confined to the area of the sting, it is not a sign of venom allergy. Only when a sting in the mouth or throat causes breathing problems is a local swelling reaction reason for a trip to the emergency room.

It’s when reactions are seen in other parts of the body that you need to be concerned about venom allergy. After a sting, Dr. Fiedler advises that you monitor your child for signs of reaction unconnected to the site of the sting. These may include:

• Significant hives or itchiness away from the sting site
• Swelling of the tongue or throat
• Difficulty breathing
• Dizziness or a dazed condition (seeming “out of it”)
• Nausea, cramps, vomiting, diarrhea or other stomach complaints

In severe reactions, a drop in blood pressure can cause a child to lose consciousness.

“If you notice any of these symptoms, seek medical help immediately,” Dr. Fielder says. “It’s not an overreaction to bring your child straight to the nearest emergency room.” There, your child will be closely observed and treatment can be given to address any life-threatening symptoms.

Treating sting reactions

If your child shows signs of or is diagnosed with a venom allergy, the immediate treatment after a sting is an injection of epinephrine, such as from an EpiPen^®.

After a sting that results in an allergic reaction, once the emergency has passed, you should have your child seen by an allergist — a doctor with special expertise in allergies. The allergist can advise on future risks and help you protect your child’s health.

Extreme local reactions to stings can be treated with steroids. If your child is stung in the mouth or throat and the swelling restricts breathing, they should be quickly taken to the closest emergency department. Steroids may also be given to provide relief when local swelling is particularly uncomfortable.

Other treatments for the discomfort and swelling of a local reaction to a sting include rubbing meat tenderizer, an aluminum-based deodorant, or a baking soda paste on the sting. Cold packs or ice cubes on the sting can also help, as can over-the-counter steroid cream (1% hydrocortisone) and antihistamines.

Protecting your child from dangerous reactions to stings

If your child is diagnosed with a venom allergy, your allergist will likely prescribe a supply of auto-injectable epinephrine, such as an EpiPen^®. The doctor will explain how to inform caregivers and school staff about the risk to your child, and when they should use the medication.

In extreme cases, your doctor may suggest venom immunotherapy, a series of allergy shots given over a long period of time, that can ultimately eliminate the risk of life-threatening reactions to stings.

Even if your child has had only local reactions to bee stings in the past, that does not mean they are safe from dangerous allergic reactions in the future. Repeated insect stings can result in a venom allergy as your child grows older.

Play it safe by keeping your child away from bees and other stinging insects. Be careful when eating, cooking, or drinking sweet drinks outdoors, as all can attract insects. Keep food covered until you are ready to eat. Avoid going barefoot in areas where bees may be feeding or nesting. If bees are nearby, slowly and calmly move away.  

If your child is stung by a bee, remove the stinger as soon as possible to stop the release of additional venom. Look for a black dot in the center of the sting. If it projects above the surface, scrape it out by running the edge of a credit card over it or lift it out with a piece of sticky tape.

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Delayed reactions to stings

Answer:

The recent update on Stinging Insect Hypersensitivity addresses immediate dermal reactions to stings and suggests that large local reactions to a sting can be monitored clinically. “Most patients with large local reactions need only symptomatic care and are not candidates for testing for venom specific IgE or venom immunotherapy (VIT). There is, however, increasing evidence that VIT significantly reduces the size and duration of large local reactions and thus might be useful in affected individuals with a history of frequent un- avoidable large local reactions and detectable venom specific IgE. The decision to give VIT for patients with large local reactions must be weighed against the added cost and potential inconvenience.” In patients with more local symptoms then “However, immunotherapy is usually not required for patients who have experienced only cutaneous systemic reactions after an insect sting. In a prospective field-sting study of children, there was a 10% chance of having a systemic reaction if re-stung (usually milder than their previous sting reactions), and a 3% or less chance of a more severe reaction. Prospective sting challenge studies in adults found a less than 3% chance of a more severe reaction in such people. VIT is still an acceptable option if there are special circumstances, such as frequent exposure, or lifestyle considerations (potential impairment in quality of life) and must be weighed against added cost and potential inconvenience. There is evidence that VIT improves the quality of the patient’s life in patients with cutaneous systemic reactions.”

There is not a lot of data on “delayed reactions” from sting reactions. The articles I could find were for the late 1980’s and may provide some guidance for the treatment of your patient.

Lichtenstein LM, Golden DB. Postscript to bee stings: delayed “serum sickness.” Hosp Pract 1983;18:36. (III).

Sakhuja V, Bhalla A, Pereira BJG, Kapoor MM, Bhusnurmath SR, Chugh KS. Acute renal failure following multiple hornet stings. Nephron 1988;49:319-21. (III).

Reisman RE, Livingston A. Late-onset allergic reactions, including serum sick-

ness, after insect stings. J Allergy Clin Immunol 1989;84:331-7. (III).

VIT could be consider for this clinical scenario but there is a paucity of data on this patient population.

Below is answer to a previous Ask the Expert question similar to yours: 8/20/2014

A 34 yo pool maintenance worker with no atopic history was seen after a bee sting in my office. After he was stung he developed a local reaction that swelled mildly and became itchy and irritated. This continued for ~ 4 days then subsided. 3 days later (1 week after the initial sting), he developed urticaria and angioedema of his lips, face and hands unresponsive to antihistamines. Symptoms eventually subsided with a 1 week course of Prednisone. ~ 3 weeks after stopping the Prednisone, pt was stung again by what he thinks was a wasp (black). He developed a local reaction but nothing further. Immunocap testing revealed class 3 to yellow hornet, paper wasp and honey bee as well as class 4 to yellow jacket.

1) It seems unlikely that an IgE mediated reaction could occur after 1 week but could the history as represented here indicate a delayed IgE-mediated reaction or a T-cell mediated reaction manifesting as urticaria and angioedema?

2) Should immunotherapy be offered/recommended given this patient’s outdoor occupation and risk for more severe reactions?

3) Pt was rechallenged soon after above events and experienced no untoward effect. Is that reassuring in any way?

A: The reaction, delayed urticaria and angioedema after an insect sting, that you described has been reported in the literature (see abstract copied below), and the author of this report, Dr. Robert Reisman, a nationally recognized authority in hymenoptera allergy, did choose to treat the patients described with venom immunotherapy. Thus there is precedence in the literature to do so. However, the numbers are exceedingly small, but they are all that we have to my knowledge.

Also serum sickness-like reactions have been reported to hymenoptera venom as reported in the same article mentioned above, and the urticaria could have been a component of such reaction. Thus, there is no definitive answer to your question as to whether or not to administer immunotherapy, but my own opinion would be not to treat at this time. Nevertheless, as mentioned, you do have at least some evidence in the literature that this treatment could be effective (see abstract copied below). Unfortunately, in my opinion, the re-sting without reaction does not give you any assurance that he would not react upon further stings.

In summary, I do not believe you could be criticized either way – that is, should you choose to treat or withhold treatment with immunotherapy based upon the above observations. But my best guess is that his urticaria and angioedema, if at all related to the sting, would more than likely be a serum sickness-like response and thus not require immunotherapy. And unfortunately, I do not think that the fact that he was stung again will give you any solace as to whether or not he might react in the future.

Thank you again for your inquiry and we hope this response is helpful to you.

J Allergy Clin Immunol. 1989 Sep;84(3):331-7.

Late-onset allergic reactions, including serum sickness, after insect stings.

Reisman RE1, Livingston A.

Author information

1Buffalo General Hospital, Department of Medicine, State University of New York 14203.

Abstract

Allergic reactions after insect stings may have a delayed onset, differing from the usual immediate anaphylactic pattern. Ten patients, aged 6 to 78 years, had allergic reactions 1 to 2 weeks after an insect sting. Six patients had had multiple stings preceding the reaction. In two instances, immediate anaphylaxis also occurred. Four of the 10 patients had serum sickness-type reactions; two other patients had more severe anaphylactic symptoms, including throat edema. All patients in this group had venom-specific IgE; four of the 10 patients had serum venom-specific IgG. Eight patients subsequently received venom immunotherapy (VIT). There have been no reactions from seven re-stings. Five patients had generalized hives starting 6 to 24 hours after an insect sting. All patients in this group had venom-specific IgE; three patients have received VIT. Two other patients developed hives, one with throat edema 3 days after an insect sting. Both patients had high titers of serum venom-specific IgE; neither patient has received VIT, one patient because of extreme sensitivity. These observations suggest that after an insect sting, patients may develop delayed-onset allergic symptoms that range from typical anaphylaxis to serum sickness and are mediated by venom-specific IgE. VIT is recommended for patients with these reactions.

Sincerely,

Phil Lieberman, M.D.

I hope all this information has been helpful.

Andrew Murphy MD FAAAAI

90,000 what to do in case of a bite

What you need to know about hymenoptera venom allergy and how to avoid mosquitoes? Svetlana Mikhailovna Shvets, an allergist-immunologist, candidate of medical sciences, senior researcher of the Department of Allergology and Immunotherapy of the Federal State Budgetary Institution “State Research Center Institute of Immunology” of the FMBA of Russia, answers the questions of readers.

– Svetlana Mikhailovna, who is at risk for allergy to bee and wasp venom?

– Mainly those who are often stung: beekeepers and everyone who helps them, usually family members.According to various authors, the prevalence of allergies among beekeepers ranges from 35–38%, and in the population as a whole – from 0.3% to 3%. Those at risk are also those who are more often in nature and, accordingly, are more likely to be stung: villagers and summer residents who work in household plots, pick berries, make jam. The risk of developing an allergy to hymenoptera venom is also higher with other forms of allergy.

– Are there any intersections between bee and wasp venom?

– They, together with ants, belong to the order of Hymenoptera.There is a slight resemblance to the poisons, but patients who are allergic to bees very rarely react to wasps, although there are times when one person is allergic to both bees and wasps.

– A four-year-old child has been bitten by a wasp, but there is no reaction. Does this mean that the next bite will also not react?

– Most likely.

– Are strong reactions like angioedema or anaphylactic shock possible at the first sting of a bee or a wasp?

– Probably not.It happens that an allergic reaction occurs at the first sting, but more often allergies develop in those who are regularly stung. There may be pronounced local edema when stinging in the face or in the eye, which is often confused with angioedema. But this is a local reaction.

– Can pills remove a mild local reaction?

– Local reaction is edema at the site of the sting. A normal reaction is pain, swelling at the sting site with a diameter of several centimeters; symptoms usually disappear after a few hours.A local allergic reaction is a swelling of more than 10 cm in diameter that persists for more than 24 hours. To reduce edema, it is recommended to take antihistamines, a cold compress to the sting site, ointments with corticosteroids; perhaps the appointment of corticosteroids in tablets. If we are talking about systemic allergic reactions, such as urticaria, abdominal pain, dyspnea, angioedema, pressure reduction, then drugs in ampoules are used. Therapy should be prescribed by a doctor. On the recommendation of an allergist, patients at risk of systemic reactions should carry an emergency kit and, in the event of a sting, be able to self-inject themselves.It is also important to quickly remove the sting when it comes to the bee.

But I would like to advise all readers, before purchasing any medications, to go to an allergist. They will receive competent advice, in particular, they will be told how to prevent stinging.

– What should be the order of administration of drugs when stinging: first suprastin, and if it does not help, then dexamethasone or all at once?

– If we are talking about a systemic reaction to the venom of bees or wasps, then first you need to inject adrenaline.Then a corticosteroid: either dexamethasone or prednisone. Prednisolone in this situation is preferable, because it begins to act a little faster. That is, the sequence is as follows: adrenaline, hormone, antihistamine: suprastin or tavegil.

– First aid for insect bites if you don’t have an adrenaline autoinjector?

– Adrenaline in ampoules for parenteral administration, intramuscularly; you need to buy a syringe for it.

– If a wasp bites, do I need to immediately give an injection of dexamethasone just in case?

– Just in case, you don’t need to inject either prednisone or dexamethasone.If there is no history of allergy to hymenoptera venom, but there is another allergy, such as hay fever, then there will be no reaction when stinging. Injections are done only if there have already been systemic reactions.

– What is the dosage of suprastin and dexamethasone injections for children of different ages?

– It is necessary to consult an allergist at the place of residence.

– A strong reaction to mosquito bites, horseflies: the bite site swells, does not go away for a long time. If several mosquitoes bite at once, the voice may hoarse.We take antihistamines, apply a napkin moistened with dexamethasone and suprastin (in an ampoule) to the site of the bite. So the doctor recommended. Are we doing the right thing or is there any other remedy for the bites? “Fenistil”, “Psilo-balm” are ineffective.

– I would recommend applying to the bite site creams or ointments of the combined type – “Pimafukort”, “Triderm”, which, in addition to a corticosteroid, include antibacterial drugs. The fact is that mosquito bites are often infected, sometimes even complicated by erysipelas, which patients sometimes mistake for a local allergic reaction.At the same time, cases of infection of bee and wasp stings are not described in the literature. Probably, their poison has disinfecting properties.

– For two years now (he is 5.4 years old), a swelling appears from every mosquito bite. If a mosquito bites in the eye – it is impossible to open the eyes for 2 days, it swells so much! Is it for life or can ASIT be carried out?

– ASIT for mosquito and horsefly bites is not carried out in our country. Among the allergic reactions to mosquito bites, local ones prevail, but there are also systemic reactions in the form of various rashes, Quincke’s edema, fever, runny nose, itchy eyes, abdominal pain, vomiting, and diarrhea.Mosquito intolerance usually manifests itself as local itchy papules that persist for several days. If there is a reaction to the bite, antihistamines can be taken. But it is better not to bring it to this, but to use means that repel mosquitoes. However, frequent mosquito bites over a long period of time can lead to numbness.

– Swelling in the midge. How to fight?

– Avoid Bites! Antihistamines can be taken.Topical – corticosteroids in combination with antibiotics. And be sure to consult with an allergist.

Prepared by Elena Tueva

Hormonal preparations prednisolone – “What to do if bitten by a wasp”

I had a chance to try prednisone when I was bitten by a wasp, and my leg was swollen from the groin almost to the foot. And the swelling not only did not think to subside, it continued to spread. Neither suprastin nor other conventional antihistamines helped.I had to go to the hospital. There I was sent to a skin venereologist, and he stated a strong allergic reaction. This is a direct indication for the use of Prednisolone. The injection is very painful. Injecting does not hurt, but soon, when the medicine begins to be absorbed, it is impossible to sit on the ass for some time. Therefore, usually, together with Prednisolone, a second injection of anesthetic is given.

Prednisolone begins to act immediately. My tumor stopped spreading on the day of the injection. But began to subside only the next day.At first, it seemed to split into several parts, while itching terribly hard. After a couple of days, it began to turn yellow and after five days it completely disappeared. A second injection was not needed. After one injection, it is simply enough to continue to be treated with lighter analogues, such as Zirtek or Fenistil.

In general, Prednisolone is a hormone that has anti-inflammatory effects. It is used for extremely strong local allergic reactions of the body. But if such a reaction is general, i.e. If the respiratory tract has suffered or anaphylactic shock has begun, then Prednisolone will no longer help here.Here, doctors are already using adrenaline.

Therefore, if you have ever experienced an excessive reaction to insect bites, it is imperative to carry an ampoule of Prednisolone with you. If you can’t buy it yourself, ask your doctor for a prescription. Because excessive reactions to bites tend to increase. Those. each subsequent bite will be much worse than the previous one. And it is even better not to go far from the place of medical care, because, in my opinion, you will not be able to deliver an adrenaline injection to yourself.

What to do if a child is bitten by a bee

Sooner or later, a child is faced with such a problem as an insect bite. One of the most unpleasant is the bee sting. As a rule, a bee sting is accompanied by discomfort and often leads to allergies. In some cases, people can develop severe, fatal allergic reactions. This problem has a clear medical concept – “insect allergy”.

Insect allergy is an allergic reaction caused by an insect bite.This term, respectively, can be attributed to a bee sting. In addition to bees, there are also insects close to them, which can cause allergic reactions in a child and an adult. These include: bumblebees, wasps, hornets. Before considering the main clinical manifestations of a bee sting, it is necessary to understand in more detail the main causative factor for the development of allergies – with bee venom .

Bee venom

Bee venom is a clear, slightly yellowish liquid produced by the glands of the honey bee.The poison consists of various substances that can be grouped into three main groups: enzymes, toxic polypeptides, biogenic amines. Quite difficult concepts for people without medical or biochemical education. For ease of perception, we will list only the main substances from these groups, and also indicate the main allergens and causative factors of acute allergic reactions.

Of the enzymes worth noting:

• Hyaluronidase.
• Phospholipase A2.
• Phosphatase.

Among toxic polypeptides, special attention is paid to:

• Melitin . This substance is the basis of the poison. It makes up about half of all poison.
• Apamin.
• MCD peptide.
• Sekapin.
• Tertiapine.

Basic biogenic amines:

• Histamine.
• Dopamine.
• Norepinephrine.

There are other poisonous substances, but the main ones are the above substances. Thus, the main pathological factor in bee venom is melitin.

Melitin is the main pathological factor in bee venom.

When do bees sting?

Usually, bees do not sting without provocation. They use the sting only when attacking their “enemy”. Factors leading to a bee attack:

• If you constitute a threat to their hive. Mechanical actions near the hive can provoke bees to defend themselves.
• Strong odors. Particular attention is paid to perfumery. Unpleasant odors are no exception – the smell of sweat. It can also provoke bees to attack.
• Color. Bees give preference to a light, white color. Black is perceived negatively.
• Smell of smoke. This also applies to tobacco smoke. Therefore, it is not recommended to smoke near bees.
• Bee sting. In fact, the bee sting itself is a contributing factor for subsequent attacks from the bees.During a bite, they secrete special substances that are captured by their fellows and are recognized as a signal to attack.

The above factors can cause the bee to bite you. During a sting, the bee plunges a sting, which is located at the end of its abdomen. The sting is a hollow needle through which poison enters the human body during a bite. A bee or, for example, a wasp can bite. A very important distinguishing feature of a bee sting is the preservation of the sting after a sting in the skin .Other similar insects do not leave a sting after a bite. Leaving a sting, the bee dies.

Bee sting symptoms

Symptoms after a bee sting are manifold. It all depends on the number of bites, as well as the reactivity of the body. Reactivity refers to the body’s response to a bite. In accordance with this, toxic and allergic reactions can be distinguished. Toxic reactions, as a rule, develop with multiple bites. For the development of an allergic reaction, one bite will be enough.

An allergic reaction is manifested by redness, swelling and pain at the site of the bite.

A toxic reaction is characterized by symptoms such as:

• weakness;
• lethargy;
• nausea;
• chills;
• headache.

An allergic reaction can manifest itself in different ways. In medicine, early (90-95%) and late reactions to bee stings are distinguished. Early reactions are also subdivided according to their severity.Given the high prevalence of early reactions, we will dwell on them in more detail.

As mentioned earlier, there are three degrees of severity of early reactions:

• First degree. It is characterized by the appearance of a local reaction. The child develops hyperemia (redness), swelling, pain, and itching at the site of the bite. As a rule, children, especially those with an allergic predisposition, develop general reactions – urticaria and Quincke’s edema. Urticaria is a rash on the body, similar to a nettle burn. Quincke’s edema often accompanies urticaria. It is a limited edema in places with loose subcutaneous fatty tissue. Such places include: the area of ​​the eyes, lips, ears, gaps between the fingers. Later, the child may experience toxic reactions described earlier. Also, the child’s pressure may decrease, while he will feel a headache, dizziness.
• Second degree. In addition to the symptoms of the first degree, more serious symptoms join.They are associated with spasms of the smooth muscles of the body. Smooth muscle is an accumulation of muscle cells in organs. It is found in almost every organ. A particular danger is the spasm of smooth muscle cells in the respiratory organs, which leads to difficulty breathing and suffocation. Reduction of these cells in the digestive organs leads to cramping abdominal pain, nausea, vomiting, diarrhea.
• Third degree. Most dangerous degree. It is characterized by the development of anaphylactic shock.This pathological reaction is a life-threatening condition that can be fatal without medical intervention.

An allergic reaction may be accompanied by cramping abdominal pain.

Late reactions are much less common and are characterized by the development of vasculitis – vascular inflammation. As a rule, the vessels of the skin and internal organs are involved in the process. In fact, late reactions can be seen as delayed complications of a bee sting.

Bee sting treatment

We will not consider folk remedies and homeopathic remedies. We will indicate only those drugs that have proven efficacy and will allow you to provide first aid for a bee sting. A baby bee can bite a finger, leg, eyelid, neck and other parts of the body. The most frequently asked question is: “What to do if a small child is bitten by a bee? What to do at home? ” Next, we will try to answer this question in detail.

Treatment of local reaction

If, after the bite, the child has only redness and swelling at the site of the bite, then the following measures must be taken:

1. Remove the tip. Preference is given to scratching out with a thin, blunt edge, such as a table knife or credit card. Do not squeeze the sting out, as this can further promote the sting and increase the intake of poison into the body.
2. Apply ice. This will help reduce pain and itching.
3. For severe pain syndrome, local anesthetics may be used. But they should be used very carefully, because for people with allergies they themselves are a threat and can cause unwanted allergic reactions. You can use a lidocaine patch, a eutectic mixture. This mixture contains local anesthetics in the form of a cream and is widely used in cosmetology.
4. In the future, you can use local glucocorticosteroids (for example, triamcinolone 0.1%), take antihistamines orally (loratadine, suprastin, etc.).

Topical glucocorticosteroids can be used to treat the bite.

Treatment of urticaria and angioedema

Treatment of children with urticaria and angioedema should be carried out in a hospital. In the fight against urticaria and Quincke’s edema, the following groups of drugs are used:

1. Antihistamines. These drugs are administered intramuscularly or intravenously. Often use 2.5% pipolfen solution or 2% suprastin solution.
2. Glucocorticosteroids. A 3% prednisolone solution is administered intramuscularly or intravenously. Given the current trend in pediatric practice, intravenous administration is preferred. Intravenous administration is accompanied by less severe pain syndrome, and also contributes to a more rapid achievement of the effect of the drug.
3. Enterosorbents. Prescribe enterosgel, atoxil.

According to indications with increasing laryngeal edema, intubation is performed.

Emergency care for anaphylactic shock

First of all, you need to call an ambulance and, if possible, call a medical worker for help.

Before the ambulance arrives, you can carry out a number of activities:

• Place the patient in a position with raised legs, turn his head to one side, extend the lower jaw. This will indirectly increase blood flow to the heart and allow more fresh air for the baby.
• Further adrenaline must be administered. There may be a pharmacy nearby where you can try to get it. A 0.1% solution of adrenaline is used at a dose of 0.05-0.1 ml / year of life (no more than 1 ml).
• After epinephrine, it is necessary to enter a 3% solution of prednisolone at a dose of 5 mg / kg (in 1 ml-30 mg).
• In case of absence of breathing and palpitations – cardiopulmonary resuscitation.

These actions may be enough to save the life of the victim and wait for the arrival of the ambulance team.

Most often, bee stings are accompanied by the development of local reactions. But given the high prevalence of allergies among children, it is possible that the bite can lead to severe allergic reactions. The task of the parents in this case is a quick reaction and well-coordinated action. It is necessary to call an ambulance and, if possible, provide first aid to the child. Parents of children who are allergic to insect bites should be especially alert. In their first-aid kit there should always be medicines that allow them to quickly stop these processes.

First aid for bee stings, wasps

As a rule, in the summer everyone is concerned about how to protect themselves and children from ticks and mosquitoes, but for some reason they forget about other insects and bites, which can be extremely dangerous.
⠀
How to provide first aid for a bee, wasp or hornet sting?

1. Remove the sting if it remains in the skin (remember that the sting is a stick with a circle, the poison is in a circle, so do not press from above, but remove it as if by “brushing” from the side).
2. Apply cold to the bite site (reduce the rate of absorption of the poison).
3. Inside, give any antiallergic drug (suprastin, zodiac, erius, loratadine, etc.), you can take a course for 2-5 days
4. Assess edema. If insignificant – topically apply fenistil gel, psilo-balsam (which is in the first-aid kit).
5. If significant, apply a drug that contains a glucocorticosteroid, it will quickly relieve edema by suppressing allergic and skin reactions (Advantan is possible from 4 months, locoid, elok).
6. If there is swelling and itching of the eyes, you can drop dexamethasone drops 0.1%
7. If the pain is severe, ibuprofen, paracetamol at an age-related dosage can be given orally.

Edema can last up to 1 week (in severe cases up to 2 months)

Strongly prohibited:

• squeeze poison out of the wound: promotes faster spread of poison;
• Apply soil, sand, leaves of plants as a compress: the risk of infection increases;
• massage the bite site;
• it is undesirable to wear bright clothes for nature, use sweet perfume, food, drinks (this all attracts insects).

Use a variety of repellents.

Red flags:
If bitten: dizziness, vomiting, nausea, rash, loss of consciousness, call an ambulance or consult a doctor!

Risk of developing anaphylactic shock! If there is in the first-aid kit, you know how to inject intramuscularly, you know the reaction of the body, and the dose for the child, you can 3% prednisolone or dexamethasone; adrenalin.

Ladanova Elena Sergeevna, pediatrician of the Children’s Clinic “PLUS”

Fatal Sting / Health / Independent Newspaper

Let him sit quietly on the flower.Photo by Reuters

Summer, relaxation, nature walks. Okay! Alas, this also has a downside – you can run into the bite of stinging insects: bees, wasps, hornets, bumblebees, gadflies. It is unpleasant, painful and, most importantly, dangerous. The Ministry of Health of the Russian Federation has developed leaflets on what to do in such cases.

It is known that when attacked by stinging insects, 500 bites are usually sufficient to cause death in a person who is not prone to allergies.And for those with severe allergies, this outcome can occur within minutes after a single bite. However, most people who develop such reactions have not suffered anything like this before. The less time passes from the moment of the bite to the development of symptoms, the less favorable the prognosis, according to the memo from the Ministry of Health.

Reaction usually occurs within minutes to one hour. Common reactions to a bite are short-term pain, redness around the bite site, itching, and a rise in local temperature.Redness of the skin, hives, swelling of the lips, tongue, sore throat, shortness of breath, abdominal cramps, diarrhea are alarming symptoms.

And threatening signs – grayish-bluish skin color, convulsions, loss of consciousness, inability to breathe due to swelling of the respiratory tract. 40 to 60% of deaths from anaphylactic reactions occur when the patient is unable to breathe due to edema. The second most common cause of death is shock, which develops as a result of dilated blood vessels and impaired blood circulation.One of the problems in the treatment of anaphylactic reaction is the variety of its manifestations in different victims. Even with insect bites belonging to the same species, the amount of poison that has entered the bloodstream fluctuates significantly.

People prone to allergic reactions are advised to wear a medical bracelet or necklace indicating a tendency to allergy to insect bites. Bites to the mouth or eyes are much more dangerous than bites to other parts of the body; in addition, victims react more strongly to multiple bites (especially more than 10).

The most dangerous for a person who does not suffer from allergies are bites in the throat after he has swallowed an insect that has got into food or drink, or inhaled an insect that has flown too close to an open mouth. Swelling of the airways, and in the absence of an allergic reaction, can lead to respiratory failure.

And here are the recommendations. It is necessary to examine the bite site and make sure that there is no sting left in the skin (a sting can remain only after a bee sting).If the sting remains, it should be removed by prying it with a fingernail or a knife blade, scissors, but without squeezing the end of the sting protruding above the skin with your fingers. This must be done, because poison continues to be secreted from the sting within two to three minutes after the bite. The site of the bite should be washed with soap and water, and an ice pack should be applied for 15–20 minutes to slow down the absorption of the poison and relieve pain.

Analgesics (paracetamol) are usually sufficient to relieve pain and itching. The bite can be smeared with an ointment or cream containing corticosteroids to relieve itching and swelling.With early use, diphenhydramine, suprastin, claritin, etc. can eliminate local symptoms. The condition of the victim should be monitored for at least 30 minutes, paying attention to the development of signs of an allergic reaction. Allergy-prone sufferers may be given prednisone or other antihistamines.

Do not use epinephrine for insect bites unless the victim is prone to a severe allergic reaction.

Of course, in all cases, you should seek medical attention.

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What to do if a child or an adult is bitten by a bee / wasp – clinic “Dobrobut”

What to do at home with a bee or wasp sting

Summer is the time for vacations, trips to the sea, vegetables and fruits and … wasps with bees. These insects are especially active during this season and meeting with them often turns into hostilities. A wasp can attack without even being provoked, its bite (or, more correctly, a sting) is harmless for most people, but very painful.Medical practice shows that most people do not know what to do with a wasp / bee sting, and dobrobut.com will try to change this situation.

Why bee or wasp stings are dangerous

Among all hymenoptera insects, there are several species that most often sting people. These are:

90 120

90,121 wasps;

Moreover, the first two have the dubious “honor” of being leaders in aggressive actions.

The danger of these insect bites is somewhat exaggerated. Most of those stung are not threatened by anything, except for some discomfort. At the very moment of the sting, a sharp pain and burning sensation occurs at the point of contact with the sting, which pass over time. Edema develops immediately, and the more pronounced, the more fat or loose fiber is under the wound. Redness after a bee or wasp sting is common.

The presence of fiber under the skin is an important factor affecting the general condition of a person after a sting.The danger is represented by situations when the sting is pierced into the area of ​​the lips, soft or hard palate, tongue. In this case, a pronounced local reaction occurs in the form of severe edema, which can block the upper respiratory tract, and the person will simply suffocate.

In general, the poison of wasps and bees is harmless. For him to kill a healthy person, he must be stung by several hundred insects. Even the stings of a dozen bees will only cause a general reaction in the form of a rise in temperature (more often in a child), chills, and weakness.

Much more dangerous are allergic reactions to hymenoptera venom (wasps and bees belong to this group of insects). In this case, at the first contact with the poison, sensitization occurs, that is, a failure of the immune response. The second contact triggers a chain of pathological reactions resulting in an allergy.

Localized urticaria is considered the least dangerous – the appearance within a few minutes of itching, spotty red rash on certain parts of the body (spots merge, forming an uneven form of reddened “fields”), weakness may occur, usually not expressed.Swelling at the site of a bite is no different from edema in the absence of allergies. When the rash spreads to the whole body, it is said about generalized urticaria – a more serious condition that is not yet life-threatening, but can be a harbinger of serious complications.

One of such severe conditions is Quincke’s edema. In this case, first of all, the soft tissues of the face swell – lips, eyelids, cheeks. The transition of edema to the neck is dangerous by the development of laryngeal edema – a deadly condition in which the upper airways are completely blocked.Death occurs within a few minutes from suffocation.

Anaphylactic shock is an even more dangerous, albeit rare complication of a bee or wasp sting. In this case, within a few minutes, the patient’s blood pressure sharply decreases, the pulse quickens, the rash spreads throughout the body. The skin becomes pale, cold clammy sweat appears. The outcome of anaphylactic shock is death from acute cardiovascular failure. But this is only if the patient is not helped.

Wasp or bee sting: what to do at home

If a bee stings, the first step is to remove the sting. For this purpose, tweezers or a sterile needle are used (you can ignite an ordinary sewing needle on a fire). The site of the bite is treated with any antiseptic, ice is applied to reduce the absorption of the poison into the narrowed blood vessels. Some mothers are interested in how to relieve swelling in a child after a wasp sting. Ice will help to reduce its severity.

Locally, it is desirable to apply any hormonal ointment – hydrocortisone, prednisolone.If the victim is prone to allergies or the sting occurred in a dangerous place (mouth, neck, face), he needs to take a pill of one of the antihistamines – tavegil, suprastin. Loratadine and cetirizine are not very suitable due to their rather slow onset effects.

A severe course of allergy requires administration of drugs in the form of injections. Most often, this is available only to specialists who inject adrenaline, prednisone and suprastin intramuscularly, and in critical cases, intravenously.With anaphylactic shock, drip infusion of various solutions may also be required, without which it is impossible to raise the decreased blood pressure. In addition, the victim is laid on his back, his legs are raised above the level of the head. In case of vomiting and loss of consciousness, the patient is laid on one side.

In case of Quincke’s edema, accompanied by laryngeal edema, a mini-operation may be necessary, which can only be performed by a qualified doctor. In this case, in a certain place, the soft tissues of the neck are dissected so as to open the lumen of the larynx.A tube is inserted into it, through which the victim will breathe. This operation is called cricoconicotomy and sometimes it is the only way to save a person’s life.

A wasp or bee sting is usually not dangerous, however, it always requires attention. Nobody knows how the human body will react to this kind of trauma. Therefore, at the slightest sign of trouble in the body, you must immediately call an ambulance and follow all the recommendations of doctors.

First aid for a wasp sting.Advice from an allergist

Wasp stings are quite common in the summer.

How to provide first aid in this case, the correspondent of the agency “Minsk-Novosti” was told by the doctor allergist-immunologist of the highest category, candidate of medical sciences, head of the allergology department of the health care institution “4th City Children’s Clinical Hospital” in Minsk, Dmitry Buza.

– When a wasp is bitten, a local reaction most often occurs. As a rule, it is pain, swelling and redness in the area of ​​the affected area of ​​the body.In such a situation, it is enough to wipe the bite site with hydrogen peroxide or treat with brilliant green (iodine). Place an ice pack on the site of the swelling for 15–20 minutes. For the prevention of an allergic reaction, the use of antihistamines (loratadine, ceterizine) in an age-specific dose is indicated. The victim needs to be provided with rest and abundant warm drink. Symptoms diminish within a few hours, advises D. Buza.

An allergic reaction to an insect bite develops in 1–2% of the population. The severity may vary.In addition to symptoms characteristic of a local reaction, tingling and itching of the skin, heat in the body, numbness of the limbs, increasing weakness, swelling of the face, ears, limbs, and a rash appear. Nausea and vomiting may occur. The most difficult consequence is anaphylactic shock. The victim loses consciousness, cardiac arrest and respiratory arrest are possible. In this case, only immediate medical assistance can save lives.

– At the first sign of an allergic reaction to a wasp sting, it is necessary to call an ambulance and immediately transport the victim to the nearest medical facility.First aid is no different from helping with a local reaction. First of all, you need to give an antihistamine, and if possible, hormonal (prednisolone, dexamethasone), preferably in the form of injections. If the patient is not breathing, his heart has stopped, it is necessary to do artificial respiration and closed heart massage before the ambulance arrives, the doctor advises.

Anyone who has had an allergic reaction to insect bites should always have an anti-shock kit on hand, which includes an ampoule or syringe pen with epinephrine (adrenaline) and antihistamines.

Forewarned is forearmed

Wasp sting and negative consequences can be prevented. To do this, you need to follow a few simple rules

1. Avoid hives and hornets’ nests. Refuse visits to apiaries, as well as places of sale of fruits and flowers.

2. Stay away from trash cans and compost pits.

3. Do not open the windows in the car while riding, avoid riding a motorcycle without a helmet, glasses and gloves.

4.Do not leave open bedroom windows overnight; cover them with mosquito net or gauze.

5. Try to behave calmly and do not make sudden movements when wasps or bees are around. If insects attack, cover your head with a cloth or hands and slowly move away until you are safe.

6. Do not eat or drink outdoors.

7. Avoid the use of strong-smelling cosmetics.

8. Do not walk barefoot on the grass.

9. Avoid brightly colored clothing (white, green or light brown preferred).

In addition to following the general rules, it is best for people with insect allergies to always wear a tag or bracelet with information about their diagnosis and written recommendations for urgent measures. It is also advisable to have a first-aid kit with you (ampoules of adrenaline, suprastin, prednisolone, sterile disposable syringes for subcutaneous and intramuscular administration; thin needles, rubber tourniquet). First, you need to clarify the dose of drugs with your doctor.