Bee or Yellow Jacket Sting

BEE OR YELLOW JACKET STING


Bee Stings - Hand - Enlarge Picture

Honeybee - Enlarge Picture

Hornet - Enlarge Picture

Wasp - Enlarge Picture

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.

Symptoms

  • The sting involves injecting venom into the human from the bee's stinger
  • The main symptoms are pain, swelling and redness at the sting site

Anaphylaxis

  • A severe 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

Bee Stings - Arm - Enlarge Picture

First Aid Advice for Anaphylaxis

  • Give epinephrine injection if you have an anaphylactic kit
  • Inject it into the muscle of the upper outer thigh

See More Appropriate Topic(instead of this one) If

  •  Not a bee, wasp or yellow jacket sting, see INSECT BITE
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WHEN TO CALL YOUR DOCTOR FOR BEE OF YELLOW JACKET STING

Call 911 Now (your child may need an ambulance for symptoms of anaphalxis)

  • 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
  • Speech is confused or slurred
  • Passed out or very weak
  • Previous severe allergic reaction to bees, yellow jackets, etc. (not just hives)

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)

Call Your Doctor Within 24 Hours (between 9am and 4pm) 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 in the first 24 hours is due to venom)
  • Swelling is huge (e.g., spreads beyond wrist or ankle)

Call Your Doctor During Weekday Office Hours If

  • You have other questions or concerns

Parent Care at Home If

  • Normal 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

  1. 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.
  2. 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.
  3. Pain Medicine: Give acetaminophen (e.g., Tylenol) or ibuprofen immediately for relief of pain and burning.
  4. Antihistamine: If the sting becomes itchy, give a dose of Benadryl.
  5. Hydrocortisone Cream: For itching or swelling, apply 1% hydrocortisone cream over-the-counter to the sting area 3 times per day.
  6. 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 swelling disappears after 3 to 5 days.
  7. Call Your Doctor If:
    • Develops difficulty breathing or swallowing (mainly during the 2 hours after the sting) (call 911)
    • 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.

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REFERENCES

  1. Betten D, Richardson W, Tong, T, Clark R. Massive honey bee envenomation-induced rhabdomyolysis in an adolescent. Pediatrics. 2006; 117(1): 231-235.
  2. Booker, G. Insect stings. Pediatr Rev. 2005;26(10):382-383.
  3. Krakowski A., Golden D. Hymenoptera stings: A practical guide to prevention and management. Contemp Pediatr. 2005;23(8):30-37.
  4. Schuberth KC. How dangerous are insect stings? Contemp Pediatr. 1989 May;6:69-88.
  5. Schumacher MJ, et al. Rate and quantity of delivery of venom from honeybee stings. J Allergy Clin Immunol. 1994;93:831-835.
  6. Sellinger CR. Immunotherapy for insect stings. Pediatr Rev. 1993;14:246.
  7. Sherman RA. What physicians should know about Africanized honeybees. West J Med. 1995;163:541-546.

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.

See Other Topics:

Insect Bite

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