BEE STING

Definition

  • Stung by a honeybee, bumblebee, hornet, wasp, or yellow jacket
  • The usual symptoms are localized pain, swelling, itching, and mild redness at the sting site.

General Information

  • Over 95 percent of stings are from honeybees or yellow jackets.
  • The sting injects venom into the human from the bee's stinger.
  • Tetanus booster following a sting is not considered necessary.

Anaphylaxis

  • Anaphylaxis is the medical term for a severe life-threatening allergic reaction.
  • Symptoms of anaphylaxis include: feeling faint or passing out, difficulty breathing, swelling of the tongue, hives, wheezing and/or cough. Onset of symptoms is sometimes within seconds and usually within 20 minutes.
  • Individuals who have had severe reactions to previous stings should have an anaphylaxis kit (e.g. Ana-Kit, Epi-Pen) and keep it nearby if there is any risk of a sting.

FIRST AID Advice for Anaphylaxis

  • Give epinephrine injection if you have an anaphylactic kit. Inject it into the muscle of the upper outer thigh.

See More Appropriate Topic (instead of this one) If

  • Bite or sting from an insect other than a bee, wasp or yellow jacket, see INSECT BITES

WHEN TO CALL YOUR DOCTOR FOR BEE STING

Call 911 Now (you may need an ambulance) If:

  • Passed out (fainted)
  • Wheezing or difficulty breathing
  • Hoarseness, cough or tightness in the throat or chest
  • Swollen tongue or difficulty swallowing
  • Abdominal pain or vomiting
  • Previous life-threatening reaction (not just hives or swelling) to sting. (Note: anaphylaxis usually starts within 20 minutes, and always by 2 hours following a sting.)
  • Use First Aid Advice for Anaphylaxis.

Call Your Doctor Now (night or day) If:

  • You feel weak or very sick

  • Hives or swelling elsewhere on the body
  • More than 20 stings
  • Sting inside the mouth

Call Your Doctor Within 24 Hours (between 9am and 4pm) If:

  • You think you need to be seen
  • Sting looks infected (red streaking from the sting area, yellow drainage) (Note: skin infection doesn't start until at least 24-48 hours after the sting. Any redness in the first 24 hours is due to venom.)
  • Swelling is huge (e.g. larger than 6 inches; entire hand is swollen)

Call Your Doctor During Weekday Office Hours If:

  • You have other questions or concerns

Self Care at Home If:

  • Uncomplicated bee, wasp, or yellow jacket sting and you don't think you need to be seen
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HOME CARE ADVICE FOR BEE, WASP, OR YELLOW JACKET STING

  1. Try to Remove the Stinger (if present):  
    • The stinger looks like a tiny black dot in the sting.
    • There are several different methods of removal. Removing the stinger quickly is more important than how you remove it.
    • Use a fingernail, credit card edge or knife-edge to scrape it off. Don't pull it out. (Reason: squeezes out more venom). If the stinger is below the skin surface, leave it alone.  It will be shed with normal skin healing.
    • In many cases no stinger will be present. Only bees leave their stingers. Wasps, yellow jackets, and hornets do not.
  2. Meat Tenderizer: Apply a meat tenderizer-water solution on a cotton ball for 20 minutes (EXCEPTION: near the eye).  This neutralizes the venom and decreases pain and swelling.  If not available, apply a baking soda solution for 20 minutes.  For persistent pain, massage with an ice cube for 10 minutes.
  3. Local Cold - Ice Massage Method: For pain, massage the area of the sting with an ice cube for 10 min as needed.
  4. Local Cold - Cold Pack Method:
    • Wrap a bag of ice in a towel. (or a bag of frozen vegetables, such as peas)
    • Apply this cold pack to the area of the sting for 10-20 minutes.
    • You may repeat this as needed, to relieve symptoms of pain and swelling.
  5. Pain Medication: For pain relief, take acetaminophen every 4-6 hours (Adults 650 mg) OR ibuprofen every 6-8 hours (Adults 400 mg).
    • Do not take ibuprofen if you have stomach problems, kidney disease, or other contraindications to using this type of anti-inflammatory drug. Do not use if pregnant. Do not use ibuprofen for longer than 7 days without consulting your doctor.
    • Do not take acetaminophen if you have liver disease.
    • Read the package instructions thoroughly on all medications that you take.
  6. Antihistamine: If the sting becomes itchy, take Benadryl (Adults 25-50 mg).
    • Do not take Benadryl if you have prostate problems.
    • Antihistamines may cause sleepiness. Do not drink, drive, or operate dangerous machinery while taking antihistamines.
    • Read the package instructions thoroughly on all medications that you take.
  7. Expected Course: Severe pain or burning at the site lasts 1 to 2 hours.  Normal swelling from venom can increase for 24 hours following the sting. The swelling disappears after 3 to 5 days.
  8. Call Your Doctor If:
    • Difficulty breathing or swallowing (generally develops within the first 2 hours after the sting; call 911)
    • Swelling becomes huge
    • Sting begins to look infected
    • You become worse or develop any of the "Call Your Doctor" symptoms.
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Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

Adult HouseCalls Online. Copyright © 2000-2004 David Thompson, M.D. FACEP

Reviewed 8/2004

Revised 8/2003

Revised 8/2004

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