Wasp sting - first aid and emergency measures

definition

A wasp sting occurs when a wasp penetrates a person's skin with its sting and injects its venom into it. This usually happens as part of a defense reaction of the insect, either when the wasp is directly threatened (for example, if you step on it) or when the wasp's nest is threatened. In contrast to bees, wasps have no barbs on the stinger and can sting several times without the stinger getting stuck in the skin. The human body usually reacts with a local reaction in the form of pain and later itching, swelling and redness. Normally, the pain of a wasp sting is bearable and subsides after a short time. The swelling and itching usually persist for a few days. In rare cases, a significant allergic (anaphylactic) reaction can occur, which can lead to life-threatening conditions. Even with non-allergy sufferers, stings in the mouth and throat, or in the throat, should be acted upon quickly and a clinic should be consulted, as the swelling of the airways can lead to shortness of breath.

therapy

Therapy for a wasp sting is usually not necessary. In the acute situation, attempts can be made to remove the wasp poison with a suction pad or by expressing it. You should absolutely refrain from sucking out the poison with your mouth! The puncture should also be roughly examined. Normally there is no longer a sting in the skin. If a stinger does stick, it should be carefully removed with tweezers, and the puncture site should then be disinfected with a suitable wound disinfectant. You should be very careful when pulling it out, as the poison still contained in the sting may be pressed into the skin during removal. In the event of great uncertainty, the family doctor can be consulted. The site of the puncture should then be cooled with ice. No further therapy is necessary. However, it is possible to apply an ointment that helps against insect bites - such as Fenistil®. Special sting healers are also available in the pharmacy, which can destroy the components of the poison through local heating, but they are only effective if used immediately after the sting has taken place. There are also many home remedies that can bring relief. Scratching the sting should also be avoided if it is itchy.

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When to see a doctor

It is usually not necessary to see a doctor after a wasp sting. However, if there are signs of an acute allergic reaction, an emergency doctor should be called immediately. A doctor should also be consulted if the puncture site swells excessively (larger than 10 cm in diameter) or has not improved after more than five days. As already mentioned, a family doctor can be consulted even if there is great uncertainty about pulling out.
If the puncture site is infected and, for example, pus forms at the puncture, a doctor should also be consulted to have the infection assessed more closely. However, a wasp sting is normally not dangerous. Only with over one hundred stitches at once does it become life-threatening for the non-allergic person.

Home remedies

First of all, the area of ​​the wasp sting should be cooled for a few minutes. The sooner the better. Cooling down can also help against the itching later. In addition, one also hears that heat (for example in the form of a hot spoon) helps to destroy the poison - this is true in principle, but it is generally not advised because usually either the heat is not great enough or burns can occur. Anti-stick pens from the pharmacy follow the same principle. These can be used until shortly after the sting and prevent a lengthy process. Other home remedies mainly help through an anti-inflammatory effect. For example, onion slices can be placed on the sting, or the sting can be carefully dabbed with honey or vinegar. These two can help relieve the itchiness. If the contact with one of these substances burns, then it should be avoided and the area should be rinsed thoroughly with clear, cool water. Plants and herbs from the garden can also be helpful - for example, placing lavender flowers, but also ribwort leaves, daisy flowers or sage leaves can help. However, these should only be used if no open area can be seen at the puncture, in order to avoid contamination and infection of the wound.

Read more about this: Home remedies for a wasp sting

homeopathy

There are several homeopathic ways to treat a normal wasp sting and to relieve the symptoms. However, if there are signs of an allergic reaction, the emergency doctor should be alerted. Globuli Apis mellifica 30C are generally considered to be the first choice for insect stings (especially stings from wasps, bees and hornets). It is recommended to take three Apis C30 globules as soon as possible after the bite; additional treatment such as cooling and various home remedies can further alleviate the symptoms. The globules can help in particular to subside the swelling. As an alternative to internal use, the globules can also be dissolved in boiled water and dabbed on the sting.

What can you do about the pain?

A wasp sting is often very painful for the first few minutes after the sting. Usually, however, the pain subsides after three to eight minutes. In general, the puncture site should still be cooled, as the cold not only helps against the swelling, but also acts as a natural pain reliever. Later in the course, the sting is often more itchy than painful. An antihistamine ointment or gel such as Fenistil® can be applied here. Cooling or one of the home remedies listed above can still be used here. A pain reliever is usually not necessary, but if the pain has not gone after hours, ibuprofen, for example, can be taken in low doses (one 200 mg tablet for adolescents and adults).

The sting is still there - what to do?

As a rule, the sting does not get stuck with a wasp sting because, unlike bees, wasps have no barbs on the sting and can even sting multiple times. Nevertheless, the puncture should always be examined carefully. Should the sting still be in the skin this can be carefully removed with tweezers. The site should then be treated with a suitable wound or Skin disinfectant disinfected to prevent infection. In some cases there may still be poison in the sting, which can be pressed into the skin if it is carelessly removed from the sting. This is particularly unfavorable for people with allergies, which is why a family doctor can be consulted for this. If the stinger is so deep in the skin that it cannot be removed with a pair of tweezers, it is also possible to see your doctor, who can remove the stinger more easily with the right instruments and under appropriately disinfected conditions.

Duration

It usually takes some time for a wasp sting to heal completely five and seven days, but sometimes symptoms disappear earlier. In the first few minutes after the bite, severe pain is usually felt, but this quickly subsides (after about three to eight minutes). At the same time, swelling with reddening, warming and itching begins to develop. With allergy sufferers, this swelling can be very large. The greatest expansion is achieved after two to three days and the symptoms begin to go away again. To Wasp stings are healed in five to seven days at the latest.

Wasp sting allergy

A wasp sting allergy belongs to the type I allergic reactions, which means that it is an allergy of the immediate type. An allergic reaction to a wasp sting therefore takes place within a few minutes to a few hours (maximum five to six hours) after the sting, but usually within the first hour after the sting.

In the case of an allergy sufferer, sensitization must have taken place before the allergic reaction, i.e. there must have been contact with wasp venom before, or simply put, the allergic reaction only occurs from the second sting in life.

Antibodies (Immunoglobulins) of type E (also called IgE) are released. These IgE bind to mast cells (a cell type of the immune system that occurs freely in the blood and tissue) and activate them so that they can transmit messenger substances (Cytokines) such as histamines and granzyme release. These messenger substances cause the allergic symptoms.

While swelling, redness, overheating and, at the beginning, pain and later itching are normal symptoms, these can be very pronounced in the case of a mild allergy or be supplemented by other symptoms in the case of a more severe allergy. The accompanying symptoms of a wasp venom allergy include skin rash all over the body, nausea, vomiting and headache, pressure on the chest and shortness of breath, as well as palpitations, drop in blood pressure, fainting, unconsciousness and even anaphylactic shock. It is also possible that only some of the symptoms mentioned are present.

If there are any signs of an allergic reaction, you should go to a hospital immediately or call an emergency doctor (Tel .: 112). With the help of a skin test (Intracutaneous test) can be found out beforehand under controlled conditions whether an allergy is present.

Desensitization (habituation as therapy so that the allergy is overcome) can also be carried out. This usually takes place in the hospital in order to be able to guarantee optimal care in the event of unforeseen consequences.

There are also emergency kits for known allergy sufferers that contain medication to prevent an acute reaction. Even if an emergency kit has been used successfully, the emergency doctor should be notified afterwards.

Allergy sufferers are also much more likely to have long-term effects from a wasp sting than people without allergies. Find out more about the long-term consequences here: Wasp sting - You should expect these long-term effects.

Concomitant symptoms

A wasp sting is usually immediately noticeable through severe pain, which, however, subsides after a few minutes (three to eight minutes). A red wheal a few centimeters in diameter forms as it progresses. You may notice redness, swelling, and warmth in the area of ​​the wasp sting. This reaction lasts for a few days and the wheal can take on even larger dimensions up to three days after the bite and can measure ten or more centimeters in diameter - especially with mild allergies. However, the wheal usually remains smaller. The symptoms then subside and should be gone after five to seven days.If symptoms such as a rash all over the body with itching, nausea, vomiting, dizziness or shortness of breath occur, a clinic should be visited because it is an allergic ( anaphylactic) reaction.

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swelling

The swelling is usually only in the area of ​​the wasp sting and occurs after a few minutes. Usually it has a diameter of about one to three centimeters. The swelling can also grow over time. On the second to third day after the puncture, however, it has often reached its maximum size. Here it can easily take on a diameter of over ten centimeters in the case of slight allergic reactions. Such a manifestation should be clarified by the doctor. Most of the time, the swelling is sensitive to pressure, but does not hurt all the time in the hours and days after the bite, it only itches. The swelling is also usually warm and reddened.

Read more on the topic: Swelling after a wasp sting

Inflammation and blood poisoning

A wasp sting naturally triggers a local inflammatory response. As a rule, however, this is sterile, i.e. without bacterial infestation, but triggered by the immune system, is considered a normal reaction and is essential for healing. Symptoms for this are swelling, reddening, overheating and pain, especially when pressure is applied to the stab site. In rare cases, the injection site can also become infected.In this case, dirt or a sting that got stuck on the floor caused bacteria to get into the small wound caused by the wasp sting. As a rule, the body can cope with this, but sometimes pus also forms. In this case, the family doctor should take a look at the sting to drain the pus and decide whether therapy with an antibiotic ointment or antibiotics in the form of tablets is necessary.
In some cases, blood poisoning can also occur. A distinction must be made between blood poisoning in the vernacular - the red stripe, lymphangitis - and blood poisoning from a medical point of view - so-called sepsis. If a red stripe appears, it is a natural process that is a reaction of the lymphatic system, which among other things is responsible for transporting cells of the immune system. There is a painful red stripe that spreads from the puncture site towards the trunk and heart. In rare cases, there may also be a fever and general malaise. If this occurs after an insect bite, this is not an acute emergency, but you should still see your doctor. In addition, it can be marked how far the red line has spread on the skin at a certain point in time in order to better assess the course.
In medical jargon, blood poisoning means the clinical picture of sepsis (also SIRS in the context of an inflammation: Systematic Inflammatory Response Syndrome - but mostly sepsis). One speaks of sepsis when bacteria, usually from a local source of inflammation, such as an infected wasp sting, get into the bloodstream, where they can multiply well and trigger a generalized (systemic) inflammatory reaction while they begin to spread in all sorts of different organs to fix. Typical of sepsis are the sudden onset of high fever with chills and a pronounced feeling of illness, as well as fatigue and fatigue. This is an absolute and life-threatening emergency. You should go to the nearest hospital immediately or call an emergency doctor (112)! Sepsis must always be treated with antibiotics that are administered intravenously (i.e. into the vein, by infusion).

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Emergency kit

An emergency kit for allergy sufferers (anaphylactic sufferers) is extremely important, especially in the case of allergies of the immediate type, such as wasp venom allergy. The set usually includes three medications and should only be used by people who have been instructed. Overall, however, the set is uncomplicated and can also be used by laypeople. Unfortunately, the emergency kit does not bypass the call for the emergency doctor (Tel.:112), but bridges the time until the emergency doctor arrives. In Germany, three medications are generally included in an emergency kit. First of all there is an adrenaline pre-filled syringe (adrenaline auto-injector / adrenaline pen). The adrenaline is given directly into the bloodstream and stabilizes the blood pressure and the circulation so that the patient does not go into shock (unstable circulation) or pass out. The pen is gripped with the dominant hand, the safety cap is removed and the end of the needle is then pressed firmly onto the outside of the thigh. The injection is automatic and a click indicates that it was successful. After about ten to fifteen more seconds, the injector should be removed and the injection site should be massaged for ten to fifteen seconds to ensure optimal absorption of the drug. If a second pen is included in the set, it can be used after five to fifteen minutes, provided there is no improvement in the symptoms.
Furthermore, the emergency kit contains an antihistamine, usually as a drop or an orodispersible tablet, and cortisone, also usually as a drop. Both should be taken after using the adrenaline pen. Antihistamines have a decongestant effect, so that the airways remain free and reduce allergic reactions.

Also read our topic: Allergy emergency kit

There are special emergency kits for children in which the medication has the appropriate dosage. Schoolchildren can already use the emergency kits well after they have been instructed, but it is generally advisable to give teachers or educators a briefing on excursions.

Causes of a Sting

Wasps sting if there is an acute threat to one's own life or the nest. Classically, wasp stings happen, for example, when you walk barefoot in a meadow, when you step on a wasp, or when you hit a wasp with the flat of your hand. Even in summer, when a lot of wasps are out and about and are attracted by sweet food and drinks, the animals can get through the Feeling threatened near people and possibly stabbing. You shouldn't go near a wasp's nest without special equipment, as the wasps have a strong instinct to defend the nest.

Cause of the body's reaction

Wasp venom contains various enzymes. These are proteins that allow chemical reactions to run optimally (catalyze) - for example, the cleavage of certain molecules. especially the Hyaluronidase (splits hyaluronic acid - an essential part of the space between cells) and various Phospholipases (splits so-called phospholipids, which are part of cell membranes, among other things) play an important role in the reaction. The substances contained in the poison cause local tissue destruction on the one hand and, after a few seconds to minutes, on the other hand, a reaction of the immune system and thus a slight, physiological inflammatory reaction. The body increases the temperature and blood flow locally in order to create an optimal working environment for the immune cells. We perceive this as redness, warmth and swelling. The itching is also caused by both the substances in the poison and the reaction of the immune system. Even hours or days after the wasp sting, the area can still be tender. This is mainly due to an increased sensitivity of the nerve fibers in the area of ​​the sting - a normal reaction of the body, which should tell us that it is better to protect the injured region. With a wasp sting allergy, the person's immune system reacts excessively. This can take the form of a local reaction (very large wheals or swelling), a general reaction with nausea, headache or rash all over the body, or shortness of breath and life-threatening allergic (anaphylactic) shock. The cause of this are cells that incorrectly classify the actually harmless sting as extremely dangerous and release excessive messenger substances (such as histamines). The result is a drop in blood pressure and a narrowing of the airways and thus an insufficient supply of oxygen to the brain (and other organs). Lighter forms show generalized rashes with itching and symptoms such as dizziness, nausea and vomiting.

diagnosis

Normally, the diagnosis of a wasp sting does not cause any major problems, as the culprit can be seen fleeing from the place of the sting. If this is not the case, you will initially only see one at the point of the puncture small whitish spot, sometimes with a red (bleeding) spot in the middle. A sting is usually not found, this would be typical of a bee sting, as bee stings have barbs, which is why the sting gets stuck in the skin. Wasp stings have no barbs, which is why wasps can sting multiple times. One forms in the next few minutes reddish wheals around the puncture out. Wasp stings are usually very painful at first, but the pain often goes away on its own after a few minutes (three to eight minutes) and instead becomes a uncomfortable itching felt.

Wasp sting under the foot

Wasp stings on the soles of the feet are quite common because the animals defend themselves if you step on them barefoot, for example in a meadow. They can be very annoying. Generally, however, they are not to be treated differently and not more dangerous than wasp stings on other parts of the body such as legs or arms. First of all, it should be cooled. Afterwards, each affected person must decide for himself whether he or she is able to walk on the affected foot. Usually the body reacts quickly and after two hours at the latest you can walk again without major discomfort. Nevertheless, excessive hiking or running should be avoided until it is completely symptom-free again.