Do not rely only on the internet. Consult your family doctor or community nurse.
- Ascertain the identity of the stinging insect - with a wasp there is no sting to remove and wasps are more likely than bees to cause systemic allergic reactions
- Reassure - for most people wasp stings can be treated with home or over the counter (OTC) remedies
- Prompt first aid - to avoid local & reduce severity of systemic, allergic response
- Observe – for signs of severe allergy = Anaphyaxis
- If anaphylaxis is suspected, emergency medical treatment is required within 20 – 40 minutes
Anaphylaxis may include all or some of the following:
- Itchy bumps (hives) and/or redness spreading over the body rapidly;
- Shortness of breath or wheezing or tightness in chest;
- Swelling of the mouth, face, lips or throat;
- Pallor, fainting, reduced consciousness;
- Nausea or vomiting;
- Chest pain;
- Anxiety and a sense of impending doom;
- Dropping of the tone of the voice, huskiness, feeling full or tight in the throat.
- antihistamine (topical cream to the skin soon after the sting and then consider the need for oral anti-histamine but read doses and precautions as some medical conditions and concurrent use of some medicines preclude use with the comment “excepting in emergency”)
- cooling e.g. skin protected ice application (or running cold water, or cold compress)
- elevate - if sting site allows this for example a hand or foot.
- pain relief - topical at first – cream or topical vinegar in the first 30 – 45 minutes (e.g. on cotton pad) and then consider if oral analgesia is needed.
Topical steroid creams may be advised by some health care experts but are not part of your first considerations (always be aware of the usual exclusions such as the face)
Safety considerations and actions
- Observe for signs of anaphylaxis (see above) & possible need for ambulance
- Remove to hospital or community doctor if there is oro-pharyngeal (mouth), oesophageal (throat or gullet) or peri-orbital (around the eyes) swelling
- Removal of rings
- Prevent infection (washing of area with soap and water)
- Avoid scratching (continue with topical and/or antihistamines until symptoms cease e.g. possibly around 48 hours)
- Seek health care advice for signs of local infection (increasing redness, swelling, warmth and tenderness when initial reaction to sting should have subsided)
- Refer to hospital for multiple stings (health risks may occur days later e.g. renal failure)
- Do not drive if there is a risk of faint or collapse or drowsiness after oral antihistamine
- Find a safe balance between reassurance that most stings give only mild symptoms and assessing the need for emergency care, even occasionally a 999 call
- Think about the ratio of body size to venom – a small child with two or three stings may need emergency care whereas a non-allergic adult may be able to cope with self care.
- Continuation of treatment - for up to 48 hours to reduce swelling and itch
- Guidance on when medical expertise is required
- Assess – after severe reaction a prompt visit to the family doctor is advised to discuss the need for Epipen prescription. If the person stung already has this equipment always replace it immediately after use. There may be a need to educate the patient and family on wasp sting prevention. Severely allergic people should never be alone where there is a high risk of wasp sting e.g. outdoors.
- Education on sting prevention may be useful in the immediate aftermath of a sting to avoid future stings and fear of stings developing.