Bee or Yellow Jacket Sting

DEFINITION

  • The 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

Symptoms

  • The sting involves injecting venom into the human from the bee's stinger
  • The main symptoms are pain, swelling and redness at the sting site

Anaphylaxis

  • A severe 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 0.4% of children
  • The onset of generalized hives or facial swelling following a bee sting is usually an isolated symptom, not the forerunner of anaphylaxis

See More Appropriate Topic (instead of this one) If

FIRST AID Advice for Anaphylaxis:

  • Give epinephrine injection if you have an anaphylactic kit
  • Inject it into the muscle of the upper outer thigh

WHEN TO CALL YOUR DOCTOR

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
  • Speech is confused or slurred
  • Passed out or very weak
  • Previous severe allergic reaction to bees, yellow jackets, etc. (not just hives)

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 of weight (teens over 50 stings)

Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If

  • You think your child needs to be seen
  • Sting looks infected (red streaking from the sting area, yellow drainage) (Note: infection and cellulitis don't start until at least 24-48 hours after the sting. Any redness in the first 24 hours is due to venom)
  • Swelling is huge (e.g., spreads beyond wrist or ankle)

Call Your Doctor During Weekday Office Hours If

  • You have other questions or concerns

Parent Care at Home If

  • Normal yellow jacket or bee sting and you don't think your child needs to be seen

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.
    • Don't pull it off. (Reason: squeezes out more venom).
    • 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.
    • For persistent pain, massage with an ice cube for 10 minutes.
  3. Pain Medicine: Give acetaminophen (e.g., Tylenol) or ibuprofen immediately for relief of pain and burning.
  4. Antihistamine: If the sting becomes itchy, give a dose of Benadryl.
  5. Hydrocortisone Cream: For itching or swelling, apply 1% hydrocortisone cream over-the-counter to the sting area 3 times per day.
  6. 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 swelling disappears after 3 to 5 days.
  7. Call Your Doctor If:
    • Develops difficulty breathing or swallowing (mainly during the 2 hours after the sting) (call 911)
    • 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.

Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

Author and Senior Reviewer: Barton D. Schmitt, M.D.

Last Reviewed: 7/15/2007

Last Revised: 8/5/2007

Content Set: Pediatric HouseCalls Online

Copyright 1994-2007 Barton D. Schmitt, M.D.