Allergy due to the components of the venom contained in the sting of hymenoptera can cause extensive local reactions or systemic reactions. As for the extensive local reactions edema appears at the injection site of the diameter greater than 10 cm, which can persist for 24 hours. As for the systemic reactions there are 4 degrees:
- Grade 1: Hives, itching, malaise and anxiety.
- Grade 2: 1st grade + angioedema, nausea, vomiting, chest tightness, diarrhea, pain abdominals and dizziness.
- Grade 3: 1st and 2nd degree + two of the following symptoms: dyspnea, stridor, hissing, dysarthria, confusion, dysphagia and feeling of distress.
- Grade 4°: 1°+2°+3°+ two of these symptoms: collapse, incontinence, loss of consciousness, cyanosis, and drop in blood pressure.
It is necessary to quickly remove the stinger using tweezers. Then evaluate whether ECG and blood gases are needed, but also skin tests for hymenoptera. As for treatment take antihistamines, corticosteroids, cold compresses, immobilization and elevation of the affected limb. In the case of mild forms, observation of vital parameters is recommended until symptoms improve for at least 12 hours. If severe forms observation for at least 24 hours.
Source: Mediserve‘s Medical Emergencies in Pediatrics.
