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  • Bee or Yellow Jacket Sting

    Definition

    • Stung by a honeybee, bumblebee, hornet, wasp, or yellow jacket
    • Over 95 percent of stings are from honey bees or yellow jackets
    • The main symptoms are pain and redness

    First Aid for Anaphylaxis – Epinephrine

    • Anaphylaxis is a life-threatening allergic reaction.
    • If you have epinephrine (such as Epi-pen), give it now.
    • Do this while calling 911.
    • Over 66 pounds (30 kg): Give 0.3 mg. Epi-Pen.
    • 33-66 pound (15-30 kg): Give 0.15 mg. Epi-Pen Jr.
    • Less than 33 pounds (15 kg): Give dose advised by your doctor.
    • Give the shot into the upper outer thigh in the leg straight down.
    • Can be given through clothing if needed.
    • Benadryl: After giving the Epi-pen, give Benadryl by mouth. Do this if your child is able to swallow.

    Skin Reactions to the Sting

    • The bee’s stinger injects venom into the skin. The venom is what causes the symptoms.
    • 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. The bee sting may swell for 48 hours after the sting. The swelling can be small or large. Stings on the face can cause a lot of swelling around the eye. It looks bad, but this is not serious.
    • Redness. Bee stings are often red. That doesn’t mean they are infected. Infections rarely happen with 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 hives with trouble breathing and swallowing. It starts within 2 hours of the sting.
    • This severe reaction to bee stings happens in 4 out of a 1,000 children.
    • Hives. After a bee sting, some children just develop hives all over or face swelling. Hives or face swelling alone may be able to be treated at home. But, at times, these symptoms can also lead to anaphylaxis. Be sure to call your doctor now to help decide.

    When to Call Us for Bee or Yellow Jacket Sting

    Call 911 Now (your child may need an ambulance) If:

    • For any of the following symptoms of anaphylaxis, see FIRST AID. Anaphylaxis most often starts within 20 minutes. It always starts by 2 hours after a sting.
    • Past severe allergic reaction to stings (not just hives)
    • Wheezing or trouble breathing
    • Hoarseness, cough or tightness in the throat or chest
    • Trouble swallowing or drooling
    • Speech is slurred
    • Acts or talks confused
    • Passed out or too weak to stand

    Call Us Now (night or day) If:

    • Your child looks or acts very sick
    • Hives or swelling all over the body
    • Sting inside the mouth
    • Sting on the eye
    • Stomach pain or vomiting
    • More than 5 stings for 10 pounds (5 kg) of weight. (In teens, more than 50 stings.)
    • Fever and sting looks infected (spreading redness)
    • You think your child needs to be seen urgently

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

    • You think your child needs to be seen, but not urgently
    • More than 48 hours since the sting and redness getting larger. (Note: Infection is not common. It does not start until at least 24-48 hours after the sting. Redness that starts in the first 24 hours is due to venom.)
    • Swelling is huge (4 inches or 10 cm). It spreads across a joint such as the wrist.

    Call Us During Weekday Office Hours If:

    • You have other questions or concerns

    Parent Care at Home If:

    • Normal reaction to bee or yellow jacket

    Care Advice for Bee or Yellow Jacket Sting

    What you should know:

    • Bee stings are common.
    • The main symptoms are pain and redness.
    • The swelling can be large. This does not mean it’s an allergy.
    • Here is some care advice that should help.

    Try to Remove the Stinger (if present):

    • Only honey bees leave a stinger.
    • The stinger looks like a tiny black dot in the sting.
    • Use a fingernail or credit card edge to scrape it off.
    • If the stinger is below the skin surface, leave it alone. It will come out with normal skin shedding.

    Meat Tenderizer:

    • Make a meat tenderizer paste with a little water. Use a cotton ball to rub it on the sting. Do this once for 20 minutes. Reason: This may neutralize the venom and reduce the pain and swelling. Caution: Do not use near the eye.
    • If you don’t have any, use an aluminum-based deodorant. You can also put a baking soda paste on the sting. Do this for 20 minutes.

    Cold Pack:

    • If pain does not improve after using the meat tenderizer paste, rub with an ice cube.
    • Do this for 20 minutes.

    Pain Medicine:

    • To help with the pain, give acetaminophen (such as Tylenol) or ibuprofen. Use as needed. See Dose Table.

    Steroid Cream:

    • For itching or swelling, put 1% hydrocortisone cream on the sting. No prescription is needed.
    • Use 3 times per day.

    Allergy Medicine:

    • For hives or severe itching, give a dose of Benadryl. See Dose Table.

    What to Expect:

    • Severe pain or burning at the site lasts 1 to 2 hours.
    • Normal swelling from venom can increase for 48 hours after the sting.
    • The redness can last 3 days.
    • The swelling can last 7 days.

    Call Your Doctor If:

    • Trouble breathing or swallowing occurs (mainly during the 2 hours after the sting.) Call 911.
    • Redness gets larger after 2 days
    • Swelling becomes huge
    • Sting starts to look infected
    • Your child becomes worse

    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.
    Copyright 1994-2013 Barton D. Schmitt, M.D.

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