Anaphylaxis symptoms after a bee sting

Warning signs include throat or tongue swelling, hoarse voice, wheezing, persistent cough, difficulty breathing, widespread hives, repeated vomiting, severe dizziness, confusion or collapse. A rash is not required for anaphylaxis.

Pain, redness and swelling limited to the sting area fit a local reaction. Swelling can become substantial around the nearby limb without necessarily being anaphylaxis.

Concern rises when symptoms occur away from the sting site or involve breathing, the throat, circulation or several body systems. Anaphylaxis can begin without warning and progress quickly, so treatment should follow the symptoms rather than waiting to see how large the local swelling becomes.

Give the person's prescribed adrenaline auto-injector without delay and call emergency services. Follow their individual allergy plan and the device instructions; antihistamines cannot replace adrenaline for breathing or circulation symptoms.

Help the person lie flat and do not allow standing or walking. If breathing is difficult, let them sit with legs extended; place an unconscious person who is breathing on their side. Remove a visible stinger promptly if this can be done safely, but do not postpone adrenaline while trying to find it.

Treat any throat tightness, tongue swelling, noisy or difficult breathing, wheezing, sudden hoarseness, marked dizziness, confusion, collapse, or pale and clammy appearance after a sting as an emergency. Widespread hives with vomiting or breathing symptoms also require urgent action.

Emergency observation is needed even when adrenaline produces a clear improvement, because symptoms may return. If the person becomes unresponsive and is not breathing normally, begin resuscitation if able and follow the emergency operator's directions.

Discuss whether referral for venom allergy assessment is suitable, which insect may have caused the reaction, and whether venom immunotherapy should be considered. Ask for a written plan that explains when and how to use prescribed adrenaline.

Review injector storage, expiry checks and technique with a training device. Household members, friends or colleagues may also benefit from knowing where the injector is kept and how to respond.