Bee or Yellow Jacket Sting
DEFINITION
- The child was stung by a honeybee, bumblebee, hornet, paper wasp, or yellow jacket
- Over 95 percent of stings are from honey bees or yellow jackets
Local Reactions
- The sting involves injecting venom into the human from the bee's stinger.
- The main symptoms are pain, itching, swelling and redness at the sting site.
- Severe pain or burning at the site lasts 1 to 2 hours. Itching often follows the pain.
- Swelling: Normal swelling from venom can increase for 24 hours following the sting. Stings of the upper face can cause severe swelling around the eye, but this is harmless.
- Redness: Bee stings can normally become red. That doesn't mean they are infected. Infections rarely occur in stings.
- The redness can last 3 days and the swelling 7 days.
Anaphylactic Reaction
- A severe life-threatening allergic reaction is called anaphylaxis
- The main symptoms are difficulty breathing and swallowing starting within 2 hours of the sting
- Anaphylactic reactions to bee stings occur in 0.4% of children
- The onset of generalized hives or facial swelling following a bee sting is usually an isolated symptom, not the forerunner of anaphylaxis
See More Appropriate Topic (instead of this one) If
First Aid Advice for Anaphylaxis - Epinephrine and Antihistamine (pending EMS arrival)
- Give epinephrine injection if the caller has an anaphylactic kit.
- Do this while they call 911 (Reason: life-saving advice).
- Over 66 pounds (30 kg): 0.3 mg. Auto-inject Epi-Pen or give 0.3 mg Twinject.
- 33-66 pound (15-30 kg) child: 0.15 mg. Auto-inject Epi-Pen Jr. or give 0.15 mg Twinject.
- < 33 pounds (15 kg) child: Give dosage recommended by your doctor (or 0.1 ml).
- Inject it IM into the upper outer thigh. (SC is less effective)
- Can be given through clothing if necessary.
- Give oral Benadryl or other antihistamine if the caller has it and the child is able to swallow.
First Aid Advice for Anaphylactic Shock
- Lie down with feet elevated.
WHEN TO CALL YOUR DOCTOR
Call 911 Now (your child may need an ambulance) If |
- For any of the following symptoms of anaphylaxis, see FIRST AID. Anaphylaxis usually starts within 20 minutes, and always by 2 hours following a sting.
- Wheezing or difficulty breathing
- Hoarseness, cough or tightness in the throat or chest
- Difficulty swallowing or drooling
- Speech is confused or slurred
- Passed out or very weak
- Previous severe allergic reaction to bees, yellow jackets, etc. (not just hives)
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Call Your Doctor Now (night or day) If |
- Your child looks or acts very sick
- Hives or swelling occur elsewhere on the body
- Sting inside the mouth
- Sting to the eye
- Abdominal pain or vomiting
- More than 5 stings/10 pounds of weight (teens over 50 stings)
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Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If |
- You think your child needs to be seen
- Sting looks infected (red streaking from the sting area, yellow drainage) (Note: infection and cellulitis don't start until at least 24-48 hours after the sting. Any redness starting in the first 24 hours is due to venom)
- Swelling is huge (e.g., spreads beyond wrist or ankle)
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Call Your Doctor During Weekday Office Hours If |
- You have other questions or concerns
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Parent Care at Home If |
- Normal local reaction to yellow jacket or bee sting and you don't think your child needs to be seen
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HOME CARE ADVICE FOR BEE OR YELLOW JACKET STING
- Try to Remove the Stinger (if present):
- Only honey bees leave a stinger.
- Use a fingernail or credit card edge to scrape it off.
- Don't pull it off. (Reason: squeezes out more venom).
- If the stinger is below the skin surface, leave it alone. It will be shed with normal skin healing.
- Meat Tenderizer:
- Apply a meat tenderizer-water solution on a cotton ball for 20 minutes (EXCEPTION: near the eye). This may neutralize the venom and decrease pain and swelling.
- If not available, apply aluminum-based deodorant or a baking soda solution for 20 minutes.
- For persistent pain, massage with an ice cube for 10 minutes.
- Pain Medicine: Give acetaminophen (e.g., Tylenol) or ibuprofen immediately for relief of pain and burning.
- Antihistamine: If the sting becomes itchy, give a dose of Benadryl.
- Hydrocortisone Cream: For itching or swelling, apply 1% hydrocortisone cream over-the-counter to the sting area 3 times per day.
- 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 redness can last 3 days and the swelling 7 days.
- Call Your Doctor If:
- Develops difficulty breathing or swallowing (mainly during the 2 hours after the sting) (call 911)
- Redness lasts over 3 days
- Swelling becomes huge or spreads beyond the wrist or ankle
- Sting begins to look infected
- Your child becomes worse
And remember, contact your doctor if your child develops any of the "Call Your Doctor" symptoms.
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.
Author and Senior Reviewer: Barton D. Schmitt, M.D.
Last Reviewed: 3/15/2008
Last Revised: 6/12/2008
Content Set: Pediatric HouseCalls Online
Copyright 1994-2008 Barton D. Schmitt, M.D. |