Insect Bites & Stings

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ICD10 CODE: T63.4

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.