Texas Children's Hospital - Bee or yellow jacket sting

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Bee or yellow jacket sting

Symptom definition:

The child was stung by a honeybee, bumblebee, hornet, paper wasp. or yellow jacket. Over 95 percent of stings are from honey bees or yellow jackets. The sting involves injecting venom into the human from the bee's stinger
The main symptoms are pain, swelling and redness at the sting site
A severe allergic reaction is called anaphylaxis
First aid advice for anaphylaxis: Give epinephrine injection if you have an anaphylactic kit. Inject it into the muscle of the upper outer thigh
Learn more about other types of insect bites, tick bites, spider bites, fire ant bites

Call 911 Now (your child may need an ambulance for symptoms of alaphylaxis):

Wheezing or difficulty breathing or any symptoms of anaphylaxis
Hoarseness, cough or tightness in the throat or chest
Difficulty swallowing or slurred speech
Thinking or speech is confused
Passed out or very weak
Previous severe allergic reaction to bees, yellow jackets, etc. (not just hives or swelling)
Note: anaphylaxis usually starts within 20 minutes, and always by two hours following a sting.

Call your doctor now (night or day) if:

Your child looks or acts very sick
Hives or swelling occur elsewhere on the body
More than 10 stings
Sting inside the mouth

Call your doctor within 24 hours (during regular office hours) if:

You think your child needs to be seen
Sting looks infected (red streaking from the sting area, yellow drainage) Note: Infection doesn't start until at least 24 to 48 hours after the sting. Any redness in the first 24 hours is due to venom
Swelling is huge or spreads beyond wrist or ankle

Call your doctor during weekday office hours if:

You have other questions or concerns

Parent care at home if:

Normal bee sting and you don't think your child needs to be seen

Home care advice for bee sting:

1. Try to remove the stinger (if present): Use a fingernail or credit card edge to scrape it off. Don't pull it off. (Reason: squeezes out more venom). If the stinger is below the skin surface, leave it alone. It will be shed with normal skin healing.

2. Meat tenderizer: Apply a meat tenderizer-water solution on a cotton ball for 20 minutes (Exception: Near the eye). This neutralizes the venom and decreases pain and swelling. If not available, apply aluminum-based deodorant or a baking soda solution for 20 minutes. For persistent pain, massage with an ice cube for 10 minutes.

3. Pain medicine: Give acetaminophen (e.g., Tylenol) or ibuprofen immediately for relief of pain and burning.

4. Antihistamine: If the sting becomes itchy, give a dose of Benadryl.

Expected course:

Severe pain or burning at the site lasts one to two hours.
Normal swelling from venom can increase for 24 hours following the sting. The swelling disappears after three to five days.

Call your doctor if:

Develops difficulty breathing or swallowing mainly during the two hours after the sting (call 911)
Swelling becomes huge or spreads beyond the wrist or ankle
Sting begins to look infected
Your child becomes worse or develops any of the "Call Your Doctor" symptoms.