Medicine for the Outdoors
Medicine for the Outdoors

Dr. Paul Auerbach is the world's leading outdoor health expert. His blog offers tips on outdoor safety and advice on how to handle wilderness emergencies.

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Multiple Bee Stings

A reader writes (about bee stings): "But what can be done for a victim stung many times, but who is not having an allergic reaction? I imagine this venom begins to become systemically dangerous after around 2-300 stings (assuming 500 is a lethal threshold)."

The most common cause for dangerously low blood pressure (shock) after a bee sting is an allergic reaction to the venom. The chance for this to happen is greater after multiple stings than after a single sting.

With multiple stings, the venom burden and its direct physiological effects may cause severe illness. Low blood pressure (hypotension), abnormal heart rhythms, difficulty breathing, abdominal pain, and nausea and vomiting may all be features of this sort of a reaction.

Treatment consists of administration of epinephrine by injection for the allergic reaction, and intravenous infusion of fluid to fill the cardiovascular system and reverse the low blood pressure. If the heart is beating in an abnormal rhythm, it may be necessary to administer drugs to normalize the rhythm.

If a complicated immune system reaction develops, then it may be necessary for a physician to prescribe a glucocorticoid ("steroid") medication to suppress the reaction.

Preview the 25th Anniversary & Annual Meeting of the Wilderness Medical Society, which will be held in Snowmass, Colorado July 25-30, 2008.

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Dr. Paul S. Auerbach is the world’s leading authority on wilderness medicine.