Management of Wasp Stings in One-Year-Old Children
For wasp stings in one-year-old children, immediate removal of the stinger by flicking or scraping (not squeezing) within 10-20 seconds is essential, followed by treatment with age-appropriate doses of antihistamines, cold compresses, and careful monitoring for signs of systemic reaction. 1
Initial Management
- Stinger removal: If visible, remove any stinger within 10-20 seconds by flicking or scraping it away with a fingernail. Do not grasp the venom sac as this can inject additional venom 2, 1
- Clean the area: Wash with soap and water to prevent secondary infection 1
- Apply cold compresses: This helps reduce local pain and swelling 2, 1
Medication for Local Reactions
- Antihistamines: Use age-appropriate doses of antihistamines to reduce itching
- For one-year-olds, consult with a healthcare provider for proper dosing
- Non-sedating H1 antihistamines are preferred for initial therapy 1
- Pain management: Age-appropriate acetaminophen may be used for pain relief 1
- Topical treatments: Consider topical lidocaine if the skin is intact to help relieve local pain 1
Monitoring for Systemic Reactions
Carefully monitor the child for signs of a systemic allergic reaction, which may include:
- Hives beyond the sting site
- Swelling of face, lips, or tongue
- Difficulty breathing or wheezing
- Vomiting or diarrhea
- Lethargy or unresponsiveness
Emergency Management
If signs of a systemic reaction occur:
- Administer epinephrine immediately if available (for one-year-olds: 0.01mg/kg, up to 0.3mg) via autoinjector in the anterolateral thigh 2, 1
- Call emergency services immediately
- Transport to emergency department for further evaluation and monitoring 1
Special Considerations for One-Year-Olds
- Dosing: All medications must be carefully dosed according to the child's weight
- Monitoring: Young children require closer monitoring as they cannot effectively communicate symptoms
- Airway concerns: Young children have smaller airways and are at higher risk for airway obstruction if facial or oropharyngeal swelling occurs 3
- Prevention of future stings: Dress children in light-colored clothing, avoid brightly colored clothing or flowery prints, and use age-appropriate insect repellents 1
When to Seek Medical Attention
Seek immediate medical attention if:
- This is the child's first sting and they are under 2 years old
- The sting is in or near the mouth, eye, or throat
- Multiple stings occur
- Any signs of systemic reaction develop
- The local reaction is severe or worsening after 48 hours
- Signs of infection develop (increasing redness, warmth, swelling, pus)
Follow-up Care
- Monitor the sting site for 48-72 hours for signs of infection or delayed reaction
- Consider referral to an allergist-immunologist if there is a history of severe reactions to insect stings 2, 1
Remember that antibiotics are usually not necessary for simple insect stings unless there are signs of secondary infection 2, 1.