Treatment Guide for INSECT STINGS - THE HYMENOPTERA
In the case of a normal reaction to a sting little treatment is necessary. If the sting is from a honey bee, the stinger may be protruding from the skin and should be carefully and promptly scraped away with a fingernail or blade. Pressure applied to the venom sac by grasping or squeezing it may inject more venom. The stinger itself will continue to inject venom through reflex contractions and will empty itself quickly. The sting site should be thoroughly cleansed. This can be done with soap and water, alcohol, or peroxide. A paste made of 1 ~ teaspoon of meat ten derizer or baking soda in one teaspoon of water has been suggested for ordinary wasp stings and some insect bites.
Ice and tourniquets will slow the spread of venom in the case of a generalized reaction, but care should be taken because of the problems that may result from the over-zealous use of ice. Elevation and rest may be helpful if the sting is on an arm or leg. Antihistamines don't help much in local reactions except to alleviate itching; these medications may be useful in allergic reactions, however.
The vast majority of stings produce only mild local reactions, in which the victim need do little more than cleanse the area. If signs of a generalized reaction develop, or if the victim has had a generalized reaction in the past, medical aid must be sought immediately. A tourniquet should be applied at a point above the sting site. There are commercially prepared insect sting kits that should be carried by persons who are sensitive or allergic to stings. These emergency sting kits must be obtained with a prescription. The individual should discuss with his physician the necessity for carrying one of these kits and when and how to use it. These should be carried in one's car as well as on his person if he ventures into the field or woods or any area where he is likely to encounter these insects. An additional kit should be kept at home. These kits contain an antihistamine, and usually a hypodermic of adrenalin, the most valuable drug in severe, rapid reactions. (Adrenalin aerosols for inhalation should be carried by children who may be unable to inject themselves.)
Some allergists feel that if a severe reaction is feared, adrenalin should be administered immediately after the sting. If the victim waits for symptoms of a reaction to develop, it may be too late. These drugs are generally very safe, though adrenalin may stimulate the heart, and can cause problems in people with severe high blood pressure, heart disease, or those who are taking certain medications.
Those who have suffered generalized reactions or abnormal reactions which are worsening should see an allergist. An individual who has a relatively mild generalized reaction may suffer a severe, life-threatening reaction with the very next sting. Generally, the more rapid the onset of symptoms, the more severe the reaction is likely to be. Allergy shots, utilizing the same principle as similar treatments for pollen allergies, allergic asthma, and hay fever have been successful in controlling future sting reactions and limiting their severity.
Recently, skin tests with insect venom and blood tests for antibodies to venom have been used to predict whether an individual is likely to have a severe reaction. This holds great promise.
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