What is the treatment for a yellow jacket sting?

Yellow Jacket Sting Treatment

For yellow jacket 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 like acetaminophen for symptom relief. 1

Initial Treatment

1. Clean the wound thoroughly with soap and water 1
2. Apply a cold compress or ice pack with a thin barrier between ice and skin to reduce pain and swelling 1
3. Consider topical 2.5% lidocaine ointment for local pain relief 1
4. Take oral acetaminophen for pain control 1
5. Elevate the affected limb if significant swelling is present 1

Monitoring for Complications

Monitor the sting site for 48-72 hours for:

• Signs of infection (increasing redness, warmth, pain, purulent drainage)
• Systemic symptoms (fever, chills, spreading redness beyond immediate sting area)
• Signs of allergic reaction 1

When to Seek Immediate Medical Attention

Seek emergency care for:

• Multiple stings (especially >10)
• Stings inside mouth or throat
• Signs of systemic allergic reaction:
  • Difficulty breathing
  • Widespread hives
  • Dizziness
  • Syncope
  • Tachycardia
  • Hypotension
  • Vomiting or diarrhea
  • Laryngospasm or bronchospasm 1, 2

Management of Allergic Reactions

For patients experiencing anaphylaxis:

• Administer epinephrine intramuscularly immediately 2
• Epinephrine is indicated for emergency treatment of allergic reactions (Type I), including anaphylaxis from insect stings 2

Prevention for Those with Known Allergies

• Carry self-injectable epinephrine and know how to use it 1
• Consider medical identification jewelry 1
• Refer to an allergist-immunologist for evaluation 1
• Consider venom immunotherapy (VIT) for those with history of systemic reactions and positive specific IgE tests 1

Prevention of Future Stings

• Wear protective clothing (long sleeves, pants) during outdoor activities 1
• Avoid bright colors and strong scents that attract wasps 1
• Use DEET-containing insect repellents (10-30%) 1
• Be cautious around food and drinks outdoors 1
• Use screens on windows and doors 1
• Remove nests and avoid areas with standing water 1

Special Considerations

• For immunocompromised patients or those with significant swelling, consider preemptive antibiotic therapy (3-5 days) 1
• Ensure tetanus prophylaxis is current (within 10 years) 1
• Note that a single negative reaction to a yellow jacket sting does not guarantee future safety - patients with previous anaphylaxis may still experience severe reactions to subsequent stings 3

Antibiotic Options for Infected Stings

If signs of infection develop, antibiotic options include:

• Amoxicillin-clavulanate: 875/125 mg twice daily
• Cephalexin: 250-500 mg four times daily
• Clindamycin: 300-400 mg three times daily (for penicillin-allergic patients)
• Doxycycline: 100 mg twice daily 1