Virtual Children's Hospital: CQQA: Bites and Stings

Pediatrics Common Questions, Quick Answers

Bites and Stings

Donna D'Alessandro, M.D.
Lindsay Huth, B.A.
Peer Review Status: Internally Reviewed
Creation Date: October 2001
Last Revision Date: April 2002

Common Questions, Quick Answers

When am I at risk for getting a bite or sting?

Most stings happen in the summer or fall.
Stinging insects in the U.S. are bees, yellow jackets, hornets, wasps, and fire ants.
Insects are found near bushes, trees, and grass.
Perfumes, hairsprays, scented lotions, and bright-colored clothes attract insects.

What are normal reactions to a bite or sting?

Reactions are different for everyone. Some reactions are worse than others.
Most people aren't allergic to bites or stings.
Normal reactions to a bite or sting are pain, swelling, and redness around the sting.
More of the body than the stung area might swell. The whole arm might swell after a sting near the wrist.
Swelling may last for 2 to 3 days.

How do you treat a normal reaction?

If the stinger is left in the skin, do not squeeze the stinger or pull it out. This injects more venom in the skin and can make your reaction worse.
Flick out the stinger by lifting it with a fingernail or scrape it off using the edge of a dull knife.
Disinfect the area. Keep it clean.
You can use an over-the-counter antibiotic (such as Mycitracin Ointment) to prevent infection.
Put ice on the area to bring down swelling.
You can use an anti-inflammatory Ibuprofen (such as Motrin or Advil) to bring down swelling.
Hydrocortisone cream (such as Cortaid 10) helps both itching and swelling.
If swelling is uncomfortable, ask your doctor about using an antihistamine or steroids.
Antibiotics will be needed if the sting gets infected.

What are allergic reactions to a bite or sting?

Reactions can start within minutes to an hour after being stung.
Reactions can cause hives (itchy, raised skin lumps) and itching.
Areas of the body that weren't stung may swell or itch.
The tongue could swell. The chest could be tight. It may be hard to breathe or swallow.
People who are allergic to bites and stings may get "anaphylaxis." In this condition many different parts of the body have an allergic reaction at the same time.
The person's blood pressure may drop and cause dizziness or fainting.
The person's heart may stop beating or they may become unconscious.
Allergic reactions could cause death.
After one allergic reaction to a bite or sting, it is likely the next reaction will be the same or worse.

How do you treat an allergic reaction?

Treat the bite or sting right away.
An allergic reaction is treated with epinephrine given by shot.
The doctor will teach you how to give yourself the shot (such as Epi-Pen). Always carry it with you.
GO TO THE EMERGENCY ROOM soon after getting stung in case you have an allergic reaction even after taking the shot.
In some cases, intravenous fluids, oxygen, and other treatments may be needed.
Allergic reactions can be prevented using special shots called venom immunotherapy. The venom helps your body prepare for an allergic reaction. Talk to your doctor for more information.

What can I do to avoid getting a bite or sting?

Be careful in places where stinging insects are found, especially at picnics or around open garbage cans.
Wear shoes when walking through the grass.
If your skin is covered, you are less likely to get stung.
Keep a safe distance from hives and nests. Have someone remove hives and nests near your home.

When should I call the doctor?

GO TO THE EMERGENCY ROOM if you think you're having an allergic reaction.
After 24 hours, call the doctor if you notice pus around the stung area or swelling and redness have increased.
Call the doctor if you have questions or concerns about your reaction to a bite or sting.

Quick Answers

Most stings happen in the summer or fall.
Normal reactions to a bite or sting are pain, swelling, and redness around the sting.
Flick out the stinger. Disinfect the area. Put ice on it to bring down swelling.
Allergic reactions can cause swelling, hives, and difficulty breathing.
An allergic reaction is treated with epinephrine given by shot.
Go to the emergency room if you have an allergic reaction or call the doctor if you have concerns about a normal reaction.

References

AAFP. Bites and Stings. 1997 (cited 2001 August 2). URL: http://www.quickcare.org/skin/insect.html
ACAAI. Allergic Reactions to Stings from Hornets, Wasps, Bees, and Yellow Jackets: Patient Information. 1998 October 6 (cited 2001 August 2). URL: http://allergy.mcg.edu/ALK/patinfo.html
MedicineNet.com. Stinging Insect Allergies (Bee Stings, Wasp Stings, Others). 1996-2001 (cited 2001 August 2). URL: http://www.medicineNet.com/Script/Main?Art.asp?li=MNI&ArticleKey=227&page=1

http://www.vh.org/pediatric/patient/pediatrics/cqqa/sting.html