What should you know about bee anaphylaxis?

A local sting reaction usually causes pain, redness, and swelling around the sting. Anaphylaxis affects the whole body and may cause widespread hives, swelling of the lips or tongue, throat tightness, wheezing, trouble breathing, dizziness, collapse, vomiting, or a sudden feeling that something is seriously wrong. Symptoms can begin quickly and may involve more than one body system. Wheezing is one possible warning symptom, but its absence does not rule out anaphylaxis.

If anaphylaxis is suspected, use the person’s prescribed adrenaline auto-injector immediately, following its instructions, and call emergency services. Tell the dispatcher that anaphylaxis is suspected. Lay the person down with legs raised unless breathing is easier sitting up; keep them still and do not let them walk. If symptoms do not improve, use a second prescribed injector if available and advised. Do not rely on antihistamines for breathing or circulation problems. Further observation in an emergency setting is needed because symptoms can return.

Treat breathing difficulty, throat or tongue swelling, faintness, or widespread symptoms after a sting as an emergency. Even if symptoms settle after adrenaline, emergency assessment is needed. After recovery, arrange allergy evaluation and a written emergency plan; ask how to carry and replace prescribed injectors and how to avoid future stings.

Ask whether the reaction was anaphylaxis, whether allergy testing is appropriate, how to use the injector, when to carry more than one, and whether referral for venom immunotherapy should be discussed.