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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What to Do If You're Stung by a Bee

Yellow Jacket Sting : Picture of Badly Swollen Knee
Bee sting allergy is an important cause of severe allergic reactions worldwide. Honeybees, bumblebees, wasps, hornets, and yellow jackets each possess a stinger that is used to introduce venom into the victim. A recent study showed that the yellow jacket species Vespula maculofrons, which tends to live in large underground nests, is more likely to cause a severe reaction than is the species Vespula germania. However, it is impossible to predict which victims will suffer severe reactions, so one must always be prepared for the worst.

The honeybee carries a doubly barbed stinger attached to a venom sac that pumps venom into the victim. When the bee attempts to escape after the sting, the stinger and sac remain in the victim and may continue to inject venom. Wasps, yellow jackets, hornets, and bumblebees can sting their victims multiple times.

If a victim suffers a severe allergic reaction to an insect bite or sting, it may be necessary to administer epinephrine (adrenaline). This is injected subcutaneously (just under the skin). The drug is available in allergy kits, such as EpiPen and EpiPen Jr. A new product that allows second dose administration of epinephrine for an allergic reaction is the Twinject auto-injector, that comes in two dosage sizes: 0.3 mg per dose or 0.15 mg per dose. In addition to epinephrine, the stung victim may benefit by taking an antihistamine (e.g., diphenhydramine [Benadryl]). If the stinger (and venom sac) is still felt to be present, it should be removed as quickly as possible, using the most convenient method (scraping, tweezer) available.

If a person is stung or bitten by an insect and shows any sign of a severe allergic reaction (e.g., difficulty breathing, wheezing, facial swelling, tongue thickness, weakness), he or she should seek immediate medical attention.

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About the Author

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