[BEES AND WASPS]
REACTIONS
IMMEDIATE: Pain
LOCAL: Within 1-4 hours—Appearance and subsidence of wheal and red flare; may see intense local swelling in region of sting
SYSTEMIC:
1. Mild reaction—Generalized urticaria, itching, malaise, anxiety 2. Moderate reaction—Any of the above plus generalized edema, tightness in the chest, wheezing, abdominal pain, nausea, vomiting, dizziness 3. Severe reaction—Any of the above plus labored breathing, difficulty in swallowing, hoarseness or thickened speech, marked weakness, confusion, feeling of impending disaster 4. Shock—Cyanosis, fall in BP, collapse, incontinence, unconsciousness 5. Delayed serum-sickness-like reaction (10-14 days after sting)—Fever, lymphadenopathy, malaise, headache, urticaria, polyarthritis
ANAPHYLAXIS AND SUDDEN DEATH: Many cases reported, usually in adults
TREATMENT
LOCAL FIRST AID:
1. Remove bee stinger from sting site by gently scraping with fingernail or blade to prevent further venom injection from attached venom sac 2. Wash site with soap and water 3. Apply ice packs or ammonia in 10% solution 4. Apply baking soda and water paste 5. Elevate and rest involved limb