Chris Trevino, Ph.D./ M.D.
EM Department Director,
St. Elizabeth Hospital Emergency Department
Bee and Wasp Stings
The summer months are a time for people to enjoy long warm days full of outdoor activities. Unfortunately, this is also the time that many of our flying friends, the insects, are quite plentiful. Usually insect bites are little more than a nuisance, but for some people, a bee or wasp sting can be a medical emergency.
The two most common stinging insects are the wasp and bee, but there are several subgroups of these pests: vespids, including yellow jackets, hornets, and wasps; and apids, including bumblebees and honeybees. Most allergic reactions result from yellow jacket stings.
The normal response to a bee or wasp sting is pain, slight swelling, redness, and itching, usually just near the area of the sting. First aid treatment is usually all that is needed. Remove the stinger as soon as possible, using a pair of tweezers or a credit card to "scrape" it away. Then, place an ice cube over the sting to ease the pain. Drugs called antihistamines, such as Benadryl, can also limit the discomfort if taken immediately. Aspirin, ibuprofen, or Tylenol may also be given for pain.
If you are stung by a bee and experience more severe symptoms, you may be experiencing an allergic reaction, and medical attention is recommended.
Allergic reactions to bee or wasp stings can vary and treatment can differ according to the severity of the reaction.
A local reaction occurs when there is dramatic and prolonged swelling at the site of the sting. Aches and pains in nearby joints may also occur. If the bite is near the mouth, throat or eyes, the allergic local reaction can be quite serious.
A toxic reaction often results when multiple stings have occurred. The patient may experience itching eyes, facial flushing, an overall itchy rash, and a dry cough, along with vomiting, diarrhea, light-headedness, and fainting. Other less common symptoms include headaches, fever, drowsiness, muscle spasms, and occasionally seizures. Toxic reaction symptoms usually ease within 48 hours with no permanent effects.
A systemic or anaphylactic reaction is the most dangerous response to a bee or wasp sting, and is a true medical emergency. Systemic reactions may be the result of a single sting or many stings, depending on the patient's sensitivity to the insect's venom. Most systemic reactions occur within 15 minutes of the actual sting, and nearly all take place within 6 hours of the sting. Symptoms resemble those of a toxic reaction, but may worsen to include chest or throat tightness, wheezing, shortness of breath, stomach cramps, chills and fever and loss of consciousness. Symptoms which seem minor at first can rapidly progress into anaphylactic shock, which can be fatal. Seek medical attention immediately if a systemic or anaphylactic reaction is suspected.
Treatment for Allergic Reactions
A person's reaction to a bee or wasp sting is simply the result of the body's release of a substance called histamine. In the case of a normal reaction, symptoms are mild. However, allergic reactions can result from an excessive release of histamine. Treatment for allergic reactions includes the use of antihistamines, which reduce the high amount of histamine in the body.
Speed is the most important aspect of treatment for allergic reactions, especially systemic or anaphylactic reactions. Taking the affected person to the emergency department immediately may literally mean the difference between life and death. The person will be given an injection of a medication called epinephrine hydrochloride, which is a very strong antihistamine. If symptoms persist, a second injection may be given 10 to 15 minutes later. Milder antihistamines such as Benadryl or Pepcid and steroids should also be given.
It is very important that every person who has had a systemic reaction is given an insect sting kit containing premeasured epinephrine, and learn how and when it should be used. Persons who experience severe systemic reactions should be watched for 24 to 48 hours after the episode and carefully examined for heart, kidney or neurologic problems or for bleeding.
If you have any questions regarding bee and wasp stings, please call your primary care doctor or, in case of any emergency, dial 911.
St. Elizabeth Hospital's Emergency Department is Ascension Parish's premiere emergent care facility. It is open 24 hours a day and is staffed by highly trained doctors and nurses who are committed to the health and safety of the residents of Ascension Parish.