Does this describe your child's symptoms?

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Definition

• 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 4 out of a 1,000 children

• The onset of widespread hives or facial swelling alone following a bee sting is usually an isolated symptom, not the forerunner of anaphylaxis. Your child’s doctor will decide.

If not, see these topics

•  Not a bee, wasp or yellow jacket sting, see INSECT BITES

First Aid:

First Aid Advice for Anaphylaxis - Epinephrine (pending EMS arrival)

• If you have epinephrine (Epi-pen or Twinject), give it now.

• Do this while calling 911 (Reason: life-saving advice).

• Over 66 pounds (30 kg): 0.3 mg. Auto-inject Epi-Pen or give 0.3 ml Twinject.

• 33-66 pound (15-30 kg) child: 0.15 mg. Auto-inject Epi-Pen Jr. or give 0.15 ml Twinject.

• Less than 33 pounds (15 kg) child: Give dosage recommended by your doctor. (or 0.1 ml if you have an epinephrine ampule).

• Inject it into the muscle (IM) of the upper outer thigh.

• Can be given through clothing if necessary.

• Benadryl: After giving epinephrine, give oral Benadryl or other antihistamine, if 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)

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 (5 kg) of weight (teens over 50 stings)

• Fever and sting looks infected (spreading redness)

• You think your child needs to be seen urgently

Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If

• You think your child needs to be seen, but not urgently

• Over 48 hours since the sting and redness now becoming larger (Note: infection is uncommon and doesn'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 a joint such as the wrist or ankle)

Call Your Doctor During Weekday Office Hours If

• You have other questions or concerns

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

HOME CARE ADVICE FOR BEE OR YELLOW JACKET STING