Anaphylaxis after an insect bite or sting

The reaction may begin within minutes, although timing varies. Warning signs include swelling of the tongue or throat, a hoarse voice, difficult or noisy breathing, wheezing, widespread hives, vomiting, dizziness, confusion or collapse. A large swollen area only around the bite or sting is different from anaphylaxis, but rapidly spreading or whole-body symptoms need urgent action.

Anaphylaxis can involve the airway, breathing or blood circulation. Skin changes may occur, but their absence does not rule out a severe reaction.

Use the person's epinephrine auto-injector promptly if anaphylaxis is suspected, following the device instructions, then call local emergency services. Do not wait to see whether symptoms settle. Keep the person lying flat with legs raised when possible; if breathing is difficult, let them sit with legs extended. A person who is unconscious, breathing normally and not pregnant can be placed on their side.

Remove a visible stinger by scraping it away if this can be done quickly, but never delay epinephrine. Avoid letting the person stand or walk. If symptoms continue or return and the person's action plan advises another dose, use the second auto-injector at the stated interval while help is coming.

Call emergency services for throat or tongue swelling, trouble breathing, faintness, collapse, confusion, or symptoms affecting more than one body system after a bite or sting. Hospital assessment is still needed after epinephrine appears to work because symptoms can recur and further treatment or observation may be required.

After recovery, ask which insect may have triggered the reaction, whether allergy testing is appropriate, how many auto-injectors to carry, where to store them in the UAE heat, and when they expire. Request a written action plan and practise using a trainer device with family members or colleagues.