IMMEDIATE: Fierce burning pain lasting minutes

LOCAL: (Fire Ants)

Minutes—Wheal formation 2-4 Hours—Clear fluid-filled vesicles 8-10 Hours—Cloudy fluid-filled vesicles 12-24 Hours—Umbilicated pustules on a red base, with pain and tenderness 3-8 Days—Lesions resolve; may leave scars

SYSTEMIC: Due to allergic sensitization; severity and speed of onset related to degree of sensitivity. May see wheezing, urticaria, abdominal cramps, generalized edema, nausea, vomiting, dizziness, confusion, shock

ANAPHYLAXIS AND DEATH: Rare, but reported

TREATMENT

LOCAL FIRST AID:

1. Wash sites with soap and water 2. Apply ice packs or cold compresses 3. Apply baking soda and water paste

SYSTEMIC:

1. Epinephrine (1:1,000) subcutaneous injection (0.2-0.5 ml in adults and 0.1-0.3 in children). Repeat in 5-10 min if necessary 2. Antihistamine (Benadryl, 50 mg IM)—Adult 3. Oral antihistamines ([Chart 1]) 4. Treat for shock as necessary ([Chart 2])