Bee sting may be caused by variety of different bees and may lead to severe pain, skin rash and in extreme cases anaphylactic shock. Detailed history is important since some cases may have a delayed presentation.
Management:
For local reaction
- Apply ice packs to reduce inflammation.
- Tab. Combiflam (Paracetamol 325 mg; Ibuprofen 400 mg) 1 tablet thrice a day for further 5 days.
- Tab. Okacet (Cetirizine 10 mg) 1 tablet at bedtime for 7 days.
- Oint. Soframycin (Framycetin 1%) to be applied thrice a day for secondary infection.
Systemic allergic reaction or management of anaphylaxis (combination therapy
- Inj. Vasocon (Adrenaline 1 mg/1ml 1:1000) – 0.5 ml intramuscularly.
- Inj. Primacort (Hydrocortisone 100 mg) intravenously as quickly as possible.
- Inj. Avil (Pheniramine 22.75 mg) i.v. stat.
- Tab. Wysolone 20 (Prednisolone 20 mg) 1 tablet as single dose.
For severe neurological symptoms
- Injection of specific antivenom (based on type of bite) – 5 – 20 mls i.v. given over 15 – 20 mins.
- Inj. Gardenal (Phenobarbitone 200 mg intramuscularly.
General advice:
- Remove the sting from the site.
- Plenty of oral fluids.
- Reassure patient to reduce anxiety.
- Apply soothing skin cream.
Investigations:
This condition is diagnosed based on clinical presentation.
Referral:
Consider referral to secondary care if patient fails to respond to treatment or presents with anaphylactic reaction.