BEESTING ALLERGY

i) Ways to avoid beestings

Perfumes, scented powders and fresh shoe polish attract bees. White clothing is least attractive to bees; florals, brown, black and dark red clothing attract bees. Avoid wearing scarves or billowing skirts which trap bees in folds. Never go barefoot, wear sandals or thongs out of doors. Bees like clover and lippia. Keep away when lawns are watered, or mown, flowers cut or hedges trimmed. (Watering a lawn in flower causes fermentation of sugar to alcohol and bees get sluggish and aggressive when disturbed!). Bees are attracted to the food in rubbish cans at home or on picnics; keep away from them. Don’t make fast, jerky movements when bees are nearby. However, it may be necessary to run for safety!! Don't travel with the car or truck windows down as this is a common cause of angry bees entering the driving cabin! use the ventilation system .

ii) Allergic reaction to bees vary.

Reactions may involve swelling of tongue and throat, wheezing, coughing, tightness in chest and shortness of breath; faintness, diarrhoea and vomiting; loss of consciousness and shock.

BUT DON’T PANIC, YOU ARE AT GREATER RISK OF DEATH FROM SNAKEBITE THAN FROM A BEE STING. CORRECT FIRST AID CAN GREATLY MODIFY A SEVERE REACTION.

Remember: your body’s allergic reaction is your body’s defence against what it perceives as a dangerous venom. Unlike snakebite venom, the bee is relatively harmless and it is your body’s defence that is the problem. Help your body to cope with the shock and you will be a survivor! Only the bee should go off and die!

iii) If you are stung:-

  1. Remove the sac by scraping if off. Do not squeeze the venom sac.
  2. Take emergency medication listed below.
  3. If overheated, cool off! This can be achieved by putting back of hand under running water; or wet a handkerchief or towel, cool the handkerchief by gently waving it (evaporation cools), and apply repeatedly to forehead, arms and legs. - Do not just put a wet rag on skin – this becomes a hot wet rag. Repeatedly wave rag or whatever to cool it and reapply to skin! Or simply pour cold water on hair, face, shirt, arms and legs – COOL OFF!
  4. If you are on your own and at risk of a severe reaction and have no medication with you, lie down on your side (in the coma position in case you faint!) in the shade and try to cool off as above. Don't try to drive for help; you are at risk of a serious vehicular accident.

As soon as possible after sting take emergency medication. This should be carried in a wide mouth thermos flask carried in the boot of the car, farm 'ute or motorbike saddlebag.

  1. Administer Adrenaline either as (i) adrenaline spray AKNA "Epinephrine Mist" aerosol puffer; previously available under SAS, but as from May1 2002 unavailable again (ii) or by injection either from ampoules or preloaded syringe available as "Epipen" but oxidation of the adrenaline in Epipen is often noted by a brown discoloration of the clear adrenaline solution within a few months of purchase. For this reason I prefer to equip patients with both the aerosol & glass ampoules of adrenaline which have a much greater stability. In Australia Epipen & adrenaline ampoules are available on prescription.
  2. Take antihistamine tablets e.g. Phenergan (promethazine) 10 mgm.
  3. If no Adrenaline available, use any reliever type asthma spray such as Ventolin*,. These are better than nothing if bronchospasm occurs but being specific beta2-agonists these lack the general protective effect of adrenaline which is essential in controlling the shock-like reaction which may develop in beesting allergy & anaphylaxis.

*Ventolin = salbutamol

4. Call an ambulance; in Australia crews give adrenaline.

PRECAUTIONS WITH ADRENALINE.

N.B. Betablockers should not be prescribed to allergic patients in the treatment of hypertension if there is the need for Adrenaline – because these drugs block one of the important actions of Adrenaline that treats allergy

The effects of Adrenaline may be potentiated by trycyclic antidepressants, thyroxine, sodium monoamine oxidase inhibitors (antidepressants) and some antihistamines e.g. diphenhydramine (Benadryl) and dexchlorpheniramine (Polaramine).

Administer with caution to hyperthyroid individuals, psychoneurotic individuals, individuals with cardiovascular disease, hypertension or diabetes, elderly individuals and children under 30 kg. body weight. Use in pregnancy is Category A*. (*Category A Drugs are those which have been taken by a large number of pregnant women and women of childbearing age without any proven increase in the frequency of malformations or other direct or indirect harmful effects on the fetus having been observed)

 

ADVERSE REACTIONS TO ADRENALINE

Transient and minor side effects of Adrenaline include palpitations, respiratory difficulty, pallor, dizziness, weakness, tremor, headache, throbbing, restlessness, tenseness, anxiety and fear.

Ventricular arrhythmias may follow administration of Adrenaline.

Patient should be instructed to carry at least one antihistamine tablet at all times.

If child is of school age, a tablet can be carried in a locket or similar around neck. The teachers should be warned and a Medic Alert Bracelet worn.

A small supply of tablets should be carried in the family car in a heat proof container.

I REPEAT! DO NOT PANIC. TAKE PATIENT QUIETLY TO A DOCTOR AND DISCUSS RESPONSE TO TREATMENT. IF YOU RUSH YOU MAY HAVE AN ACCIDENT MORE DANGEROUS THAN THE BEESTING!

 

The above treatment procedure may be used to treat acute allergy or anaphylaxis to a sting from a wasp or ant and may also be used in acute food allergy. It should be noted that the commonest cause of life-threatening "allergic" reactions with swelling of the tongue is actually due to the ACE inhibitors, a popular treatment for high blood pressure!

 

ADMINISTRATION OF ADRENALINE

Open ampoule and draw up 0.5 ml. in syringe provided.

Clean injection site with alcohol wipe, usually front area of middle third of upper leg if giving injection to yourself.

Injection given with needle at a 45 degree angle, subcutaneously, very slowly. Give 0.1ml – 0.3ml. over 1-2 minutes for a child and up to 0.5ml. for an adult.

Always draw back on syringe before injecting to make sure it is not in a blood vessel – if blood in syringe when drawn back, select another site.

Apply pressure with the alcohol swab when the needle is withdrawn.

Take note of the time that the Adrenaline is given and contact or report to your doctor.

Store Adrenaline injection in a cool place or in a wide mouthed thermos flask, as it is heat affected. Do not store in the glove box of the car.

 

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