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Bee or Yellow Jacket Sting

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Does this describe your child's symptoms?

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Bee Sting of Upper Arm
Bee Sting of Upper Arm :: LMS Inc. :: (click image to see Copyright)

Bee Sting of Left Hand
Bee Sting of Left Hand :: LMS Inc. :: (click image to see Copyright)

First Aid - Removing a Stinger
First Aid - Removing a Stinger :: LMS Inc. :: (click image to see Copyright)

Honeybee Collecting Pollen
Honeybee Collecting Pollen :: Wikimedia Commons :: (click image to see Copyright)

Hornet
Hornet :: Wikimedia Commons :: (click image to see Copyright)

Paper Wasp
Paper Wasp :: Wikimedia Commons :: (click image to see Copyright)

First Aid - Shock - Child
First Aid - Shock - Child :: LMS Inc. :: (click image to see Copyright)

Wasp
Wasp :: CDC PHIL :: (click image to see Copyright)

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.

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When to Call Your Doctor

call 911

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 now

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 within 24 hours

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 within 24 hours

Call Your Doctor During Weekday Office Hours If

  • You have other questions or concerns

home care

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

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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.

    • 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.

  3. Local Cold: For persistent pain, massage with an ice cube for 10 minutes.

  4. Pain Medicine: Give acetaminophen (e.g., Tylenol) or ibuprofen immediately for relief of pain and burning.

  5. Antihistamine: If the sting becomes itchy, give a dose of Benadryl. (See Dosage chart)

  6. Hydrocortisone Cream: For itching or swelling, apply 1% hydrocortisone cream to the sting area 3 times per day.  (No prescription needed)

  7. 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 redness can last 3 days and the swelling 7 days.

  8. Call Your Doctor If:

    • Develops difficulty breathing or swallowing (mainly during the 2 hours after the sting) (call 911)

    • Redness lasts over 3 days

    • 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.

© 2000-2019 The StayWell Company, LLC. 800 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.