From the Guidelines
For acute wasp sting treatment, immediate removal of the stinger, cleaning the area, and administration of epinephrine via an autoinjector if anaphylaxis occurs are crucial steps, as outlined in the 2024 American Heart Association and American Red Cross guidelines for first aid 1.
Key Treatment Steps
- Remove the stinger as soon as possible by plucking or scraping, as recommended by the guidelines 1.
- Clean the area with soap and water to prevent infection.
- Apply a cold compress or ice pack wrapped in cloth for 10-20 minutes to reduce swelling and pain.
- For mild reactions, take an oral antihistamine like diphenhydramine (Benadryl) 25-50mg every 4-6 hours to reduce itching and swelling, and use acetaminophen (Tylenol) 500-1000mg every 6 hours or ibuprofen (Advil, Motrin) 400-600mg every 6-8 hours for pain relief, as suggested by the guidelines 1.
Anaphylaxis Treatment
- If a person experiences anaphylaxis due to a wasp sting, they should self-administer epinephrine via an autoinjector, and a first aid provider should assist if necessary, as recommended by the guidelines 1.
- Activate the emergency response system if anaphylaxis occurs.
- Stings to the eye should be evaluated by a trained medical professional.
Additional Considerations
- Wasp venom contains proteins that trigger an inflammatory response, causing pain, redness, and swelling.
- Most reactions are mild and resolve within hours to days.
- However, seek immediate medical attention if you experience difficulty breathing, swelling of the face or throat, rapid pulse, dizziness, or nausea, as these may indicate a severe allergic reaction requiring emergency treatment with epinephrine, as emphasized by the guidelines 1 and supported by previous studies on stinging insect hypersensitivity 1.
From the FDA Drug Label
1 INDICATIONS & USAGE Adrenalin® is available as a single-use 1 mL vial and a multiple-use 30 mL vial for intramuscular and subcutaneous use. Emergency treatment of allergic reactions (Type I), including anaphylaxis, which may result from allergic reactions to insect stings, biting insects, foods, drugs, sera, diagnostic testing substances and other allergens, as well as idiopathic anaphylaxis or exercise-induced anaphylaxis.
The acute treatment for a wasp sting is epinephrine (IM), specifically for emergency treatment of allergic reactions (Type I), including anaphylaxis caused by insect stings 2.
- Key symptoms of anaphylaxis that may require epinephrine treatment include:
- Flushing
- Apprehension
- Syncope
- Tachycardia
- Thready or unobtainable pulse associated with hypotension
- Convulsions
- Vomiting
- Diarrhea and abdominal cramps
- Involuntary voiding
- Airway swelling
- Laryngospasm
- Bronchospasm
- Pruritus
- Urticaria or angioedema
- Swelling of the eyelids, lips, and tongue It is essential to seek medical attention if symptoms return after initial treatment or if signs of infection occur at the injection site 2.
From the Research
Acute Treatment for Wasp Stings
- The primary treatment for wasp stings, except in cases of anaphylaxis, is supportive 3.
- For anaphylaxis, treatment involves intramuscular epinephrine, recumbent posture, and adjunct measures such as IV fluids and oxygen 3.
- Patients with a history of anaphylaxis can benefit from venom immunotherapy, which reduces the risk of sting anaphylaxis by up to 98% 3.
- Proper administration of epinephrine using an autoinjector, such as an EpiPen, is crucial in emergency situations, but studies have shown that many patients are not well-trained in its use 4.
- Less than 30% of patients with venom allergy carry their EpiPen at all times, and only 22% would immediately administer it after a re-sting 4.
- Instruction on EpiPen administration provided by an allergist can improve patients' technique, highlighting the need for thorough and repeated education 4.