What is the proper care for a wasp sting?

Wasp Sting Care

For wasp stings, immediately clean the area with soap and water, apply a cold compress to reduce pain and swelling, and use over-the-counter pain relievers and antihistamines for symptom relief. 1

Initial Management

1. Clean the area:

   • Wash the sting site with soap and water to prevent secondary infection 1
   • Remove any visible stinger (unlike bees, wasps can sting multiple times and typically don't leave stingers behind) 2

2. Reduce pain and swelling:

   • Apply cold compresses to the affected area for 10-15 minutes 1
   • Use over-the-counter pain relievers like acetaminophen or NSAIDs 1
   • Apply topical lidocaine if skin is intact to relieve local pain 1

3. Control itching and inflammation:

   • Take oral antihistamines for symptom relief 1
   • Apply topical corticosteroids for delayed hypersensitivity reactions 1

Types of Reactions and Management

Local Reactions

• Characterized by redness, swelling, itching, and pain at the sting site 1
• Treatment: Follow initial management steps above

Large Local Reactions

• Defined as swelling >10cm in diameter, increasing for 24-48 hours, taking 5-10 days to resolve 1
• Treatment: Same as local reactions but may require more aggressive symptom management

Systemic Reactions (Medical Emergency)

• Symptoms include urticaria, respiratory symptoms, cardiovascular symptoms 1
• Seek immediate medical attention if any of these occur 1
• Emergency treatment includes epinephrine for anaphylaxis 3

Warning Signs Requiring Medical Attention

• Difficulty breathing or swallowing
• Swelling of face, lips, throat, or tongue
• Dizziness or fainting
• Rapid heartbeat
• Nausea, vomiting, or diarrhea
• Widespread hives or rash beyond the sting site

Special Considerations

Monitoring

• Monitor the sting site for 48-72 hours for signs of infection or delayed reaction 1
• Be aware that rare but serious complications can occur, including stroke and other neurological complications 4, 5

Prevention

• Wear long sleeves, long pants, and closed shoes in areas where wasps may be present 1
• Apply DEET-containing repellents (10-30% concentration) 1
• Avoid areas with high uncut grass, weeds, and low brush, especially during warm months 1

High-Risk Individuals

• Patients with a history of systemic reactions should carry injectable epinephrine 1
• Patients with mastocytosis are prone to very severe reactions 6
• Referral to an allergist is recommended for patients who have experienced systemic allergic reactions 1

Common Pitfalls to Avoid

• Don't delay seeking medical attention if signs of systemic reaction occur
• Don't apply tight bandages over sting sites as this can worsen swelling
• Don't assume antibiotics are needed unless there are signs of infection 1
• Don't underestimate the potential severity - while most wasp stings are self-limiting, they can occasionally cause serious complications 4, 2