Insect Bites & Stings

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Causes

• Bees, wasps, hornets and ants: venom is usually mild and causes only local reaction but may cause anaphylactic shock in previously sensitized persons
• Spiders and scorpions: Most are non-venomous or only mildly venomous
• Other stinging insects

Clinical features
Swelling, discolouration, burning sensation, pain at the site of the sting
There may be signs of anaphylactic shock.

Differential diagnosis
Allergic reaction

Management

Treatment

LOC

If the sting remains implanted in the skin, carefully remove with a needle or knife blade Apply cold water/ice If severe local reaction Give chlorpheniramine 4 mg every 6 hours (max: 24 mg daily) until swelling subsides Child 1-2 years: 1 mg every 12 hours Child 2-5 years: 1 mg every 6 hours (max: 6 mg daily) Child 6-12 years: 2 mg every 6 hours (max: 12 mg daily) Apply calamine lotion prn every 6 hours If very painful scorpion sting Infiltrate 2 ml of lignocaine 2% around the area of the bite If signs of systemic envenomation Refer

HC2

Prevention

• Clear overgrown vegetation/bushes around the home
• Prevent children from playing in the bush
• Cover exposed skin while moving in the bush
• Use pest control methods to clear insect colonies.