From the Guidelines
The common name for emergency treatment of anaphylaxis caused by a Hymenoptera sting is an epinephrine auto-injector, often known by the brand name EpiPen. When someone experiences a severe allergic reaction to a bee, wasp, hornet, or other stinging insect from the Hymenoptera order, immediate administration of epinephrine is the first-line treatment, as stated in the practice parameter update 2011 1. The standard adult dose is 0.3mg of epinephrine, while children typically receive 0.15mg, injected into the outer thigh muscle.
- The auto-injector should be held firmly against the thigh for 3-10 seconds (depending on the specific device) to ensure complete delivery of the medication.
- After using an epinephrine auto-injector, the person should seek emergency medical care immediately, even if symptoms appear to improve, as a second wave of symptoms can occur, as mentioned in the study 1. Epinephrine works by constricting blood vessels to increase blood pressure, relaxing airway muscles to improve breathing, and reducing hives and swelling.
- People with known Hymenoptera allergies should carry an epinephrine auto-injector at all times, especially during outdoor activities when exposure risk is higher.
- It is also important to note that patients with a history of systemic reactions to Hymenoptera stings should be considered for allergen immunotherapy, as stated in the practice parameter update 2011 1. The management of patients with a positive history and negative venom skin test results requires clinical judgment and ongoing research, as acknowledged by the AAAAI Insect Committee 1.
- Patients selected for immunotherapy should be cooperative and compliant, and the decision to administer immunotherapy should be made on an individual basis after analysis of potential risks and benefits, as mentioned in the study 1.
- VIT greatly reduces the risk of systemic reactions in stinging insect–sensitive patients with an efficacy of up to 98%, as stated in the practice parameter update 2011 1.
From the FDA Drug Label
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 common name for the emergency treatment of anaphylaxis caused by a Hymenoptera sting is Epinephrine 2.
- Key points:
- Epinephrine is used for emergency treatment of allergic reactions, including anaphylaxis.
- Anaphylaxis can be caused by Hymenoptera stings, among other allergens.
From the Research
Emergency Treatment for Anaphylaxis
- The common name for emergency treatment of anaphylaxis caused by a Hymenoptera sting is adrenaline autoinjector, also known as epinephrine autoinjector 3, 4.
Administration of Emergency Treatment
- Patients with a history of systemic allergic reactions to Hymenoptera stings should carry an emergency kit containing an adrenaline autoinjector, H1-antihistamines, and corticosteroids 3.
- The proper and primary means of treating acute anaphylaxis is immediate epinephrine, which is often underutilized in the acute setting 4.
Prevention of Further Systemic Sting Reactions
- Venom immunotherapy is the only treatment to prevent further systemic sting reactions and is indicated in venom-allergic children and adults 3, 5.
- Venom immunotherapy is also recommended in adults with only generalized skin reactions as it results in significant improvements in quality of life compared to carrying an adrenaline autoinjector 3.