Insect Bites and Stings

[Singing Bridge]

Continuing with our present theme of environmental emergencies, I thought I would add insect bites and stings. This is a very basic review as there are many different types of specific stings and bites that have individualized treatment recommendations. When in doubt, call 911.

General signs and symptoms of bites and stings include:

 History of bites and stings.
 Bite mark or stinger embedded in the skin.
 Immediate pain that is severe or burning.
 Numbness at the site after a few hours.
 Redness or other discoloration of the skin around the bite or sting.
 Swelling around the site, sometimes spreading gradually.

If the patient has an allergic reaction, any combination of a range of signs and symptoms may develop. They include the following:

Skin
 Warm, tingling feeling in the mouth, face, chest, feet, and hands.
 Itching, hives, and flushing.
 Swelling of the tongue, face, neck, hands, and feet.

Respiratory system
 Tightness in the throat or chest.
 Cough, hoarseness (losing the voice).
 Rapid or labored breathing.
 Noisy breathing, stridor, wheezing.

Circulatory system
 Increased heart rate.
 Decreased blood pressure.

General findings
 Itchy, watery eyes.
 Headache.
 Runny nose.
 Sense of impending doom.
 Decreasing mental status.

Reference:

Limmer, Daniel, and Keith Karren and Brent Hafen. First Responder: A Skills Approach. New Jersey: Pearson, 2007.

Has anyone ever had to deal with insect bites and stings? Stories and experiences shared may help us deal with situations in the future. What treatments were tried, and did they work? I'll follow up with some potential treatment recommendations in another post to follow.

[dan]

Sense of impending doom.

That right there is a bad symptom

I have lost a couple relatives to having an allergic reaction to bee stings...
One of them was never allergic before and had been stung many times but somehow developed an allergic response since the last time he was stung.
I believe he died from his airway swelling shut. He was dead within minutes and before paramedics could get there...

My worst bites have come from spiders. ( we are talking insects )
My strangest bite has come from an African scorpion that I had as a pet about 20 some years ago.

Insects can be much more dangerous than they are given credit. Mosquitos and ticks are known for causing terrible desease's, bees and spiders can cause severe alergic reactions.

[Singing Bridge]

I've seen a "sense of impending doom" used to describe a symptom of a number of medical emergencies over the years Dan, and it's never good!

Very sorry to hear of the relatives lost, an anaphylactic reaction can be life threatening in a hurry. I am allergic to bee stings myself and have had one life threatening instance. I was stung on the neck, a very vascular area, and was shocked to begin having major symptoms in less than 120 seconds- incredible! I had hives everywhere with extreme itching, followed by starting to lose my voice and hoarseness from swelling. Wheezing began next... fortunately I had epinephrine and benadryl immediately available. My reaction was so severe and lengthy I received more epinephrine and diphenhydramine in ER, along with steroids. I've been stung twice since with no reaction whatsoever, but I'm always at the ready... except for a lesson learned. I hit the woods in September for some scouting and walked onto a yellow jacket nest underground, they all attacked. My Epi pen was in a pack in the Otter sled I was pulling, and I ran away to escape the yellowjackets. Real lucky I didn't react- always carry Epi pens On Your Person, Nowhere else! I know an Army Ranger that always has his Epi pen in a buttoned/velcro uniform pocket at all times.

[publiclandhunter]

Bridge,

Good info. The epi-pen is a good idea to have on you or in your pack while in the woods - even if you aren't alergic to the stings. Your body can do crazy things and there are instances of people getting stung that supposedly "weren't allergic to stings" that developed sudden threatening symptoms. Better safe than sorry!

PLH

[publiclandhunter]

Boone & Crockett mosquitoes exist in the U.P. Eh?

[Singing Bridge]

Your body can do crazy things and there are instances of people getting stung that supposedly "weren't allergic to stings" that developed sudden threatening symptoms.

Exactly, PLH- adult onset of allergies is becoming more and more common, it seems and can involve a variety of differing types.

That is one serious mosquito!

[wmahunter]

I got bitten by deer flies once that made my finger swell. Had to use some wet cigarette tobacco to ease the pain. I am allergic to yellow jackets, wasps, bees etc.

Now I have a better solution that works on yellow jackets, wasps and bee stings. It works great.
Meat tenderizer. A couple of drops of water, form a paste and let it sit. It pulls the pain and swelling away.

Yes, I carry this in my pack now along with a benadryl in case the allergy effects are worse.

Where do you get epi-pens? that sounds like a good idea also.

[headgear]

Funny you should bump this wma, I was on a walk with the fam last night and stopped to collect a few milkweed pods. Sure enough I must have stepped on some kind of nest and got nailed twice on the back of my foot (wearing sandals). Hurt like but I walked it off and in an hour all was well. I've been stung several times before with no alergic reaction but it's good to know this stuff just in case something happens.

[Singing Bridge]

I got bitten by deer flies once that made my finger swell. Had to use some wet cigarette tobacco to ease the pain. I am allergic to yellow jackets, wasps, bees etc.

Now I have a better solution that works on yellow jackets, wasps and bee stings. It works great.
Meat tenderizer. A couple of drops of water, form a paste and let it sit. It pulls the pain and swelling away.

Yes, I carry this in my pack now along with a benadryl in case the allergy effects are worse.

Where do you get epi-pens? that sounds like a good idea also.

Sorry I missed this one.... You get Epi pens (epinephrine) prescribed to you by your doctor. They also make a pediatric Epi pen where the dose is cut in half, as Epi is a powerful drug. Epi pens have expiration dates on them, don't forget to get new ones when the old ones expire.

[Singing Bridge]

Its that time of year again, where people can get into real trouble with insect bites / stings, especially the people allergic to "bee" stings.

Heat emergencies are definitely a concern during the summer, but if EMS can get to you and you are still breathing, there is an excellent chance you will survive. If you had seizures and were unconscious, you cooked some brain cells and your recovery will show any long term damage as you go along.

Severe allergic reactions to bee stings or other critters are very dangerous, and may be life threatening even when EMS arrives prior to unconsciousness in the patient. When the respiratory system is compromised, your life is in great danger. Many of the allergic reactions I see never get to the point where the patient's throat swells and they begin losing their voice, sometimes with heavy wheezing and severe respiratory compromise... but when the allergic reaction IS severe it only takes a couple of minutes for someone to be in grave danger.

I am encountering more and more people each year, it seems, who have been stung by bee's / wasps / yellow jackets during their lifetime and never had a real problem... and then it happens- a full blown anaphylactic reaction (allergic reaction) to a sting that particular day... it is not unusual for this to happen and we all should be aware of it.

[whitetail007]

i use to carry the pen with me but like someone said they expire. now i carry benadryl and just go to the dr. office when i get stung. had a close call 2 years ago when i stepped on a nest of ground bee's back in a tamarrack marsh, luckily i didnt get stung. i bet i picked 50 bee's off my sweatshirt that had there stingers stuck. i can take one sting and be fine getting to the doctor without much worry, more than that and it get serious quick. i got stung in the lip by a little sweat bee and was in the ER for 6 hours so you really just never know, maybe i better go get another pen

[Singing Bridge]

i use to carry the pen with me but like someone said they expire. now i carry benadryl and just go to the dr. office when i get stung. had a close call 2 years ago when i stepped on a nest of ground bee's back in a tamarrack marsh, luckily i didnt get stung. i bet i picked 50 bee's off my sweatshirt that had there stingers stuck. i can take one sting and be fine getting to the doctor without much worry, more than that and it get serious quick. i got stung in the lip by a little sweat bee and was in the ER for 6 hours so you really just never know, maybe i better go get another pen

Please get an Epi pen- it is that important. I know they aren't cheap, but your life is worth a lot!

Benadryl is an antihistamine, an important and effective drug to fight / slow / stop the histamine release caused by an allergic reaction.

Epinephrine (Epi Pen) is a front-line drug used by EMS and Emergency Departments to combat severe allergic reactions... there is a reason we give it first- it directly impacts your respiratory system and your ability to breathe.

Also, as to your experiences above- sting location and the ability of the sting "venom" to be absorbed has a lot more to do with your reaction than the "number" of stings. If you look at my posts above, you will see that one sting to the neck hit me in less than two minutes... the neck is a very vascular area with a lot of veins and arteries... whereas I have been stung on the leg and arm since with either a slow or non-existent reaction due to the sting location. Don't misunderstand me, there are also certain areas on arms and legs with a lot of blood vessels, but I got lucky.

[dan]

We just had retraining... The company will no longer allow us to administer an epi-pen shot for a patient because of guys having the pen backwords and there thumb over the back and shooting themselves in the thumb. Apparently, guys are loosing there thumbs over it. But if a guy goes unconscious I am not allowed to "legally" administer the shot as a 1st responder. I a m literally required to watch him die, if paramedics with more advanced training and allowances don't get there in time. The sad truth is, without the epi shot, you can die in minutes, much faster than help can get to you.

I had a patient who is allergic to peanuts eat something cooked in peanut oil at work and his head swelled up twice normal size. Luckily we got him advanced help in time before his airway shut down.

[gjs4]

Your body can do crazy things and there are instances of people getting stung that supposedly "weren't allergic to stings" that developed sudden threatening symptoms.

Exactly, PLH- adult onset of allergies is becoming more and more common, it seems and can involve a variety of differing types.

That is one serious mosquito!

If i get stung above my collar bone i puff up externally like a demon form Buffy the Vampire slayer... yet i havebeen stung almost 3 dozen times on the torso and hurt for a couple hrs then itched so bad i wanted to rip my skin off... yellow jackets are rampant here.

My kids get giant lumps form mosquito bites- wife and i do not....so to each there own.

After bite, jewelweed or sliced onions on the sting help us... my mom is an epipen carrier for bee stings and goes into anaphalctic (sp) shock w any bee sting

[Stanley]

Brake cleaner works as a defense spray. Used it more than once while cleaning parts. Puts those wasps and hornets down and sprays a long ways. I leave spiders alone, they eat bugs.