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Wasp Sting Treatment: Step-by-Step First Aid and When to Seek Emergency Care

Immediate First Aid (Do in Order)

  1. Stay calm – Panic increases heart rate → faster venom spread.
  2. Remove stinger if present – Wasps usually don't leave stingers (unlike bees). If visible, scrape off with card/fingernail. Do not squeeze.
  3. Wash thoroughly – Soap and water. Reduces venom load and infection risk.
  4. Cold compress – Ice pack wrapped in cloth, 10 min on/10 min off. Reduces pain, swelling, venom diffusion.
  5. Elevate – If on limb, raise above heart.
  6. Oral antihistamine – Cetirizine 10 mg or loratadine 10 mg (non-sedating preferred). Diphenhydramine 25–50 mg if sedating okay.
  7. Pain relief – Ibuprofen 400–600 mg or acetaminophen 1000 mg.
  8. Topical – Hydrocortisone 1% cream or calamine lotion for itching.
  9. Monitor – Watch for systemic reaction for 2–4 hours.

Signs of Anaphylaxis – CALL 911 IMMEDIATELY

  • Difficulty breathing, wheezing, stridor, throat tightness
  • Swelling of lips, tongue, face, throat
  • Dizziness, fainting, confusion (hypotension)
  • Widespread hives, flushing, itching
  • Nausea, vomiting, abdominal cramps, diarrhea
  • Rapid, weak pulse; sense of doom

If anaphylaxis: Epinephrine auto-injector IM (mid-outer thigh) → 911 → lie flat, legs elevated → second dose in 5–15 min if no improvement. Antihistamines and inhalers are adjuncts only – epinephrine is first-line.

Signs of Infection (24–72 hours later)

  • Increasing pain, redness, warmth, swelling beyond initial area
  • Pus, red streaks (lymphangitis)
  • Fever >100.4°F (38°C)

→ See clinician for possible antibiotics.

Large Local Reaction (>10 cm)

  • Not anaphylaxis. Treated with oral prednisone taper (e.g., 40–60 mg/day x 3–5 days) + antihistamine.
  • Allergist referral if recurrent – consider venom immunotherapy (98% effective).

Prevention

  • Avoid perfumes, bright colors, open food/drink outdoors.
  • Don't swat; move slowly away.
  • Keep epinephrine auto-injector if history of systemic reaction.

Most wasp stings are painful but self-limited. Know the red flags. Carry epinephrine if allergic.

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