From the Guidelines
To treat a sting, the first step is to remove the stinger by scraping it off with a fingernail, which should be done within the first 10 to 20 seconds to prevent additional venom injection, as recommended by 1. The procedure for treating a sting involves several key steps to minimize the risk of an allergic reaction and reduce discomfort.
- Remove the stinger: This should be done carefully to avoid squeezing the venom sac and injecting more venom into the skin.
- Clean the area: Use soap and water to clean the affected area, which helps prevent infection.
- Apply a cold compress: A cold compress can help reduce swelling and pain by constricting blood vessels and reducing inflammation, as mentioned in 2 and 3. For pain relief and to reduce itching and inflammation, consider the following:
- Take acetaminophen (Tylenol) 500-1000mg every 6 hours or ibuprofen (Advil, Motrin) 400-600mg every 6-8 hours as needed.
- Apply a topical antihistamine cream like diphenhydramine (Benadryl) or hydrocortisone 1% cream. It's crucial to recognize the signs of a severe reaction, which may include difficulty breathing, facial swelling, dizziness, or widespread hives. If any of these symptoms occur, seek emergency medical attention immediately, as they may indicate anaphylaxis, a potentially life-threatening condition, as emphasized by 1, 2, and 3. People with known severe allergies should always carry an epinephrine auto-injector (EpiPen) and use it immediately if symptoms of anaphylaxis develop, as the prompt administration of epinephrine is critical in preventing fatal outcomes, as highlighted by 1.
From the Research
Sting Procedure
The sting procedure is not directly described in the provided studies. However, some studies mention injection techniques that may be relevant:
- The "peppering technique" is described in 4, where the tender area is injected with 40 to 50 injections by injecting, withdrawing, redirecting, and reinserting without emerging from the skin.
- Intralesional corticosteroid injections are discussed in 5, where the purpose is to attain a high concentration of the drug at the diseased site with minimal systemic absorption.
- Ultrasound guided injection is mentioned in 6, where it is used to treat recalcitrant plantar fasciitis.
- Treatment for stinging insect allergy is described in 7, which includes supportive care, intramuscular epinephrine for anaphylaxis, and venom immunotherapy for long-term management.
Key Points
- The peppering technique involves multiple injections in a tender area.
- Intralesional corticosteroid injections aim to deliver a high concentration of the drug to the diseased site.
- Ultrasound guided injection can be used to treat conditions like plantar fasciitis.
- Treatment for stinging insect allergy depends on the severity of the reaction and may include venom immunotherapy.