When to Seek Medical Care

Mild localized itching, swelling, or discomfort warrants contacting your healthcare provider for guidance.

If local symptoms worsen over several days, it may indicate an infection at the sting site, characterized by pain, increased swelling, redness, and warmth. In such cases, call your healthcare provider for a same-day appointment.

If you've had a reaction in the past, even if you've used an epinephrine injection kit for the sting, it's essential to go immediately to your medical office or the nearest hospital emergency department. You still need evaluation to ensure your symptoms are resolving and not recurring.

Hives, rash, swelling all over your body, difficulty breathing or swallowing, and dizziness or fainting are signs of an anaphylactic reaction and require immediate medical attention.

1. If you experience severe symptoms or symptoms all over your body, head to a hospital emergency department.
2. Do not drive yourself to the hospital.
3. If no one is available to drive you immediately, call 911 for emergency medical transport. If possible, inform the dispatcher that you are having a reaction to a sting.
4. While waiting for the ambulance, take self-treatment measures.

Self-Care at Home

For most insect stings, home care is sufficient.

1. If insects are near you, stay calm, gently brush them from your skin, and leave the area quietly and swiftly.
2. If the stinger is still in your skin, especially after honeybee stings, remove it promptly by scraping the site perpendicular to the skin with a credit card or similar device. Avoid pinching the stinger to prevent more venom injection.
3. Manage local swelling by elevating the affected body part, applying ice, and removing tight-fitting jewelry from the sting area to prevent compression of the blood supply.
4. Control pain with ibuprofen or acetaminophen.
5. For itching, take an antihistamine pill like diphenhydramine (Benadryl). Use hydrocortisone cream for relief. A paste of baking soda or salt and water may also help, as well as over-the-counter lotions like calamine. Do not break any blisters if they develop.

Don't be alarmed if the reaction takes 2-5 days to heal. Continue treatment until all symptoms disappear. In cases of severe reactions, do not attempt self-treatment. Call your healthcare provider or 911 based on symptom severity. Do not drive yourself. If immediate transportation is unavailable, call for an ambulance. For symptoms of anaphylaxis, here's what to do while awaiting the ambulance:

1. Stay calm.
2. Leave the area where the insects are.
3. If swallowing is not difficult, take an antihistamine (1-2 tablets or capsules of diphenhydramine [Benadryl]).
4. If wheezing or breathing difficulty occurs, use an inhaled bronchodilator like albuterol or epinephrine if available, as they dilate the airway.
5. If you feel light-headed or faint, lie down and raise your legs higher than your head to improve blood flow to your brain.
6. If you have an epinephrine kit, follow the instructions for self-injection. The kit contains a premeasured dose of epinephrine, a prescription medication that rapidly reverses the most severe symptoms. Bystanders should administer CPR to an unconscious person who stops breathing or has no pulse.
7. If possible, provide medical personnel with information about the medications you've taken today, your usual medications, and any known allergies.

Follow-up

Ensure that all your healthcare providers are aware of the type of reaction you experienced. If you had a severe or widespread reaction, you should receive a prescription for an epinephrine injection kit (EpiPen) upon leaving the hospital.

1. This kit contains a premeasured dose of epinephrine in an easy-to-use syringe.
2. You would inject yourself in the thigh muscle with the epinephrine at the first sign of a reaction.
3. A healthcare provider or the food allergy & anaphylaxis network's website can instruct you on kit usage.
4. It is recommended to keep two or more kits in different locations and have one with you at all times for sting-related emergencies.

If you've experienced a severe or widespread reaction to an insect sting, consult an allergist for desensitization therapy, which is available for some types of venom allergies.

Prevention

Take precautions to avoid future insect stings:

1. Avoid nests or hives of stinging insects.
2. Avoid wearing bright clothing or perfumes that might attract bees and wasps.
3. Stay calm and quiet when near flying insects, moving slowly.
4. Exercise caution around food or drinks outdoors, especially sweet foods like soft drinks that attract stinging insects.

Evaluation by an allergist for desensitization injections can be beneficial. Obtain one or more epinephrine injection kits if prescribed, keeping them in convenient locations and ensuring family members and close friends know how to use them. In case of kit use, seek immediate medical attention from your healthcare provider or a hospital emergency department.