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A child stung by an insect - what to do?

A child stung by an insect - what to do?


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Holidays and the spring period is the time when our children are particularly exposed to insect stings (mainly bees, wasps and hornets). Most of these types of accidents lead to life-threatening health and child health, local skin reaction. Unfortunately, 0.3 - 0.8% of children can develop generalized reaction, which is a state of immediate threat to life and requires urgent help. This percentage increases for babies allergic to Hymenoptera venom and may be even 6%.

Insect sting - symptoms

There are four basic types of reactions after insect stings. Of these, the following can be mentioned (from the most common to the rarest):

  • Normal local (non-allergic) - characterized by pain, swelling and erythema at the sting site. It usually develops within a few minutes of the accident and disappears after a few days without leaving any traces.
  • Major local (allergic) reaction - similarly to the usual reaction, it is characterized by pain, erythema and swelling (diameter over 10 cm) at the sting site. Local symptoms may be accompanied by a feeling of breakage, fever, chills, headaches and painful enlargement of local lymph nodes. This reaction is particularly dangerous if the sting affects the neck and face region (swelling can lead to life-threatening breathing problems).
  • Generalized (allergic) reaction - characterized by generalized urticaria, itchy skin and a number of symptoms from all organs and systems (in its course may appear dizziness, abdominal pain, chest pain, diarrhea, nausea, vomiting, shortness of breath, hoarseness, cyanosis, pressure drop, or disturbed consciousness). The rupture develops most often within a few minutes of the sting (we rarely deal with the so-called two-phase reaction - reoccurrence of symptoms after a few to several hours after the sting). A generalized reaction is a state of immediate threat to life and requires urgent medical attention (about which in a moment).
  • Generalized toxic (nonallergic) reaction - the result of simultaneous sting by many insects. Muscle damage (called rhabdomyolysis), heart, kidney or liver damage may occur. Just like a generalized allergic reaction, it is a life-threatening condition and also requires urgent medical attention.

Insect sting - proceedings

What to do after an insect stings depends on:

  • from an insect species,
  • the type of sting reaction and
  • funds available on site.

Normal local (non-allergic) - in the case of a bee sting, it is necessary to fastest sting removal (technique is important - the sting should be lifted with a flat object and in no case should it be squeezed) What's more, the sting site can be washed with a disinfectant and closely monitored the child at home for the next hours and days. If any disturbing symptoms appear, an urgent visit to the doctor is necessary.

Major local (allergic) reaction - as before, remove the sting first. Then go to the pediatrician with your child (you can apply cold compresses to relieve pain and swelling at the sting site).

Large local reaction around the neck and face - if you have an adrenaline pre-filled syringe at home (parents of children allergic to Hymenoptera venom), give it intramuscularly to the outer thigh, and then urgently take the child to the hospital emergency department or call an ambulance card.

Generalized (allergic) reaction - as before, inject adrenaline, and then urgently let your child get to the Emergency Room or call an ambulance. In the event of unconsciousness and a simultaneous lack of breath or pulse, chest compressions and rescue breaths should be started (CPR - 30 compressions to 2 rescue breaths).

Generalized toxic (nonallergic) reaction - as in the case of a generalized allergic reaction.

In summary, insect stings are relatively common and every parent should be able to deal with their child's occurrence. This is especially true for parents whose children are allergic to venom (the key is to have and be able to use adrenaline pre-filled syringes, which is the primary life-saving medicine in these cases).

Bibliography:Pediatrics by Wanda KawalecInternal Szczeklik 2018/19Guidelines of the European Resuscitation Council 2015



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