Skip to main content

Sting, Bee, Emergency Medicine

Reviewed 06/2017
 


Basics

Description

  • Injection of hymenoptera venom causes:

    • Release of biologic amines

    • Local or systemic allergic reactions

  • Reactions are:

    • Usually IgE-mediated type I hypersensitivity reactions

    • Rarely type II...

Diagnosis

Signs and Symptoms

History

History and physical exam—keys to diagnosis 

Physical Exam

5 types of reactions to stings: 
  • Local reaction:

    • Most common type of reaction

    • Local pain, erythema, and edema a...

Treatment

Pre-Hospital

Most deaths occur within 1st hour owing to either respiratory obstruction or anaphylaxis causing cardiovascular and respiratory collapse. 

Initial Stabilization/Therapy

Acute Severe Systemic Reaction/Anaphylaxis

Follow-Up

Disposition

Admission Criteria

  • Worsening symptoms, airway compromise

  • Persistent unstable vital signs require ICU admission.

  • Life-threatening reaction requires 24-hr observation.

  • Systemic reaction...

Pearls and Pitfalls

  • Treat patients who present with systemic reactions to bee stings aggressively.

  • Provide prescriptions for EpiPen to patients discharged after presenting with life-threatening reactio...

Additional Reading

  • Bahna  SL. Insect sting allergy: A matter of life and death. Pediatr Ann.  2000;29:753–758.

  • Freeman  T. Stings of hymenoptera insects: Reaction types and acute management. UpToD...

Codes

ICD9

989.5 Toxic effect of venom 

ICD10

T63.441A Toxic effect of venom of bees, accidental, init 

SNOMED

  • 241820008 Bee sting (disorder)

  • 282095007 Allergic reaction to bee sting (disorder)

  • 241931004 Bee...

Subscribe to Access Full Content

Sign Up for a 10-Day Free Trial

Sign up for a 10-day FREE Trial now and receive full access to all content.

 
×