What is the treatment for a wasp sting?

Wasp Sting Treatment

For wasp stings, immediate treatment includes removing the stinger (if present), washing with soap and water, applying ice or cold compresses, and using over-the-counter pain relievers and antihistamines for symptom management. 1

Initial Management

1. Immediate wound care:

   • Remove the stinger immediately if present (wasps can typically sting multiple times without losing their stinger, unlike bees) 1, 2
   • Clean the area thoroughly with soap and water 1
   • Apply cold compresses or ice packs with a thin barrier between ice and skin to reduce pain and swelling 1

2. Symptom management:

   • Take oral antihistamines to reduce itching and swelling 1
   • Use acetaminophen or NSAIDs for pain relief 1
   • Apply topical treatments such as lidocaine or corticosteroid lotions for local symptom relief 2

Monitoring for Allergic Reactions

Watch for signs of allergic reactions, which can range from mild to severe:

• Local reactions: Redness, swelling, and pain at the sting site 1, 2
• Regional reactions: More extensive swelling beyond the sting site 2
• Systemic reactions (anaphylaxis): Require immediate medical attention 1
  • Signs include: flushing, syncope, tachycardia, hypotension, convulsions, vomiting, diarrhea, abdominal cramps, airway swelling, laryngospasm, bronchospasm, pruritus, urticaria, and angioedema 3

Emergency Treatment for Anaphylaxis

If signs of anaphylaxis develop:

• Administer intramuscular epinephrine immediately - this is the first-line treatment 1, 3
  • Adult dose: 0.3-0.5 mg
  • Children dose: 0.01 mg/kg up to 0.3 mg
• Seek emergency medical attention immediately 1
• Patients with known allergies should carry autoinjectable epinephrine 1

Special Considerations

1. Tetanus prophylaxis:

   • Not routinely needed after simple insect stings unless tetanus vaccination is not current 1
   • Consider a tetanus booster if it's been more than 5 years since the last dose for contaminated wounds 1

2. Antibiotic prophylaxis:

   • Not indicated for uncomplicated stings 1
   • May be considered if signs of infection develop or in high-risk patients (immunocompromised, asplenic, advanced liver disease) 1

3. Alternative treatment options:

   • Concentrated heat application has shown promise in reducing swelling, pain, and itching quickly after insect stings 4

Prevention of Future Stings

• Have known nests removed by professionals 1
• Avoid wearing bright colors or flowery prints 1
• Wear protective clothing (long pants, long sleeves, closed shoes) 1
• Individuals with history of systemic reactions should be referred to an allergist-immunologist for consideration of venom immunotherapy 1, 5

Common Pitfalls and Caveats

• Never delay epinephrine administration in cases of anaphylaxis to try other medications first 1
• The onset of life-threatening anaphylactic signs typically occurs within 10 minutes of the sting, requiring prompt recognition and treatment 2
• Anaphylactic reactions are not dose-dependent or related to the number of stings 2
• Patients with mastocytosis are at higher risk for severe reactions to insect stings 5
• Venom immunotherapy significantly reduces the risk of subsequent systemic reactions from as high as 60% to as low as 5% 1, 5