Insect Bites and Stings: First Aid, Infection Signs and When to Call 911

What it involves

MedlinePlus says insect bites and stings can cause an immediate skin reaction. Fire ant bites and the stings of bees, wasps, and hornets are most often painful, while bites from mosquitoes, fleas, and mites are more likely to itch. In most cases they can be treated easily at home, though a few people have severe allergic reactions that need immediate treatment.

Who this is for

• Patients with a bite or sting that is getting more red, swollen, or painful over days
• Patients who had a larger-than-expected reaction to a sting
• Patients who want to know when a spider bite needs a visit
• Patients who have had a bodywide reaction before and want a plan

What to expect

• Questions about what bit or stung you, when, and how the area has changed
• A look at the skin for spreading redness, warmth, or signs of infection
• A plain plan for itch, swelling, and wound care, plus antibiotics only if infection is likely
• Advice on what to carry and what to do if a reaction happens again

Call 911 for these signs

MedlinePlus warns that some people have life-threatening allergic reactions to bee stings or insect bites, called anaphylaxis, which can come on quickly and affect the whole body. Call 911 if someone with a sting has trouble breathing, wheezing, swelling of the face or mouth, throat tightness, difficulty swallowing, weakness, or turns blue. Other warning signs it lists include chest pain, vomiting, fainting, and a rash or flushed skin. Do not wait for an appointment.

First aid for most bites and stings

MedlinePlus gives these steps for ordinary bites and stings:

• Scrape the stinger out with the edge of a credit card, and do not use tweezers, which can squeeze more venom in
• Wash the area thoroughly with soap and water
• Put ice wrapped in a washcloth on the site for 10 minutes on, then 10 minutes off
• Take an antihistamine or apply an itch-relief cream if needed
• Watch over the next several days for increasing redness, swelling, or pain

What not to do

MedlinePlus says not to apply a tourniquet, and not to give stimulants, aspirin, or other pain medicine to a person unless a provider has prescribed it. If the person has an emergency kit such as an EpiPen, MedlinePlus says to use it and to remove rings and tight items near the area because it may swell.

Spiders and the rare serious bites

MedlinePlus says most spider bites are harmless, but certain bites, such as the black widow or brown recluse, can cause serious illness. If it is safe to do so, bring the insect or spider with you for identification. A bite with severe pain, a spreading sore, fever, or muscle cramps deserves a visit the same day. The wound care page explains how the practice handles open sores and skin injuries.

When a bite is probably infected

MedlinePlus says to watch for increasing redness, swelling, or pain over the days after a bite or sting, which suggests infection. Red streaks, warmth, pus, or fever are other reasons to be seen promptly. A rash that is not clearly tied to a bite is sorted in the skin conditions guide, and a bite that comes with fever is described in the adult fever guide.

After a bodywide reaction

MedlinePlus says that if you had a severe, bodywide reaction to a bee sting, your provider should refer you to an allergist for skin testing and therapy, and you should receive an emergency kit to carry with you. A primary care visit is the right place to start that referral and to review which medicines you should keep on hand.

Preventing the next one

MedlinePlus advises avoiding perfumes and dark or floral-patterned clothing in areas with many bees, avoiding quick, jerky movements near hives or nests, and not putting your hands in nests or under rotted wood. It also recommends caution when eating outdoors, especially with sweet drinks or near garbage cans, which attract bees.

Sources

• MedlinePlus — Insect bites and stings
• MedlinePlus — Insect Bites and Stings health topic