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Bee or Yellow Jacket Sting

Symptoms:

Stings can be from a honeybee, bumblebee, hornet, paper wasp, or yellow jacket. More than 95% of stings are from honey bees or yellow jackets. Infections rarely occur in stings. The main symptoms are pain, swelling, and redness at the sting site.

Three types of reactions

  • Local Reaction:
  • Systemic Venom Reaction: history of multiple stings; larger venom dose; systemic symptoms include vomiting, diarrhea, and dizziness
  • Anaphylactic Reaction: severe life-threatening allergic reaction to sting

Local Reaction

  • Main symptoms are localized pain, swelling, itching, and redness at stinger site.
  • Normal swelling from venom can increase for 24 hours following the sting. Stings of the upper face can cause severe swelling around the eye, but is harmless. Swelling can last 7 days.
  • Redness: The redness can last 3 days.

Systemic Reaction: Number of Stings and Delayed Venom Toxicity

  • Large-volume envenomation can cause nonallergic systemic symptoms such as vomiting and diarrhea within 8 hours of the stings.
  • This venom reaction can progress over 24 hours to hemolysis, rhabdomyolysis, and renal failure.
  • Death from massive envenomation occurs mainly in adults with more than 500 stings.

Anaphylactic Reaction

  • A severe life-threatening allergic reaction is called anaphylaxis.
  • The main symptoms are difficulty breathing, difficulty swallowing, and hypotension (manifested by fainting or too weak to stand).
  • If no symptoms occur by 2 hours, the risk for anaphylaxis has passed.

First Aid Advice for Anaphylaxis (Pending EMS Arrival)

  • While calling 911, give epinephrine injection if anaphylactic kit is available.
  • Injection can be given through clothing if necessary.
  • Give oral Benadryl or other antihistamine if available and the child is able to swallow.

Home Care Advice

  1. Try to remove the stinger (if present):
    • Only honeybees leave a stinger.
    • Use a fingernail or card edge to scrape it off.
    • Don’t pull it off (squeezes out more venom).
    • If the stinger is below the skin surface, leave it alone. It will be shed with normal skin healing.
  2. Meat tenderizer:
  3. Apply a meat tenderizer-water solution on a cotton ball for 20 minutes, but not near the ear. This may neutralize the venom and decrease pain and swelling.
  4. If not available, apply aluminum-based deodorant or a baking soda solution for 20 minutes.
  5. For persistent pain, massage with ice for 10 minutes.
  6. Pain medicine: Give acetaminophen (e.g. Tylenol) OR ibuprofen.
  7. Antihistamine: If the sting becomes itchy, give a dose of Benadryl.
  8. Hydrocortisone cream: For itching or swelling, apply over-the-counter 1% hydrocortisone cream to the sting area 3 times per day.
  9. Expected course:
    • Severe pain or burning at the site lasts 1-2 hours.
    • Itching, swelling and redness often follow the pain.
    • The redness can last 3 days and the swelling of 7 days.
    • Call back if:
      • Develops difficulty breathing or swallowing (mainly during the 2 hours after the sting) (call 911).
      • Redness lasts >3 days.
      • Swelling becomes huge or spreads beyond the wrist or ankle.
      • Sting begins to look infected.
      • Your child becomes worse.
 

Information on this site is intended for Angel Kids Pediatrics patients only. Always consult your doctor before beginning, modifying, or discontinuing any treatment plan.

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