Bee stings and allergies: how to remove a sting and signs of anaphylaxis

TUREFF• •0

If you keep bees, you will be stung. For most people a sting is painful and swollen for a few days and nothing more. For a small number of people, a sting can trigger anaphylaxis, a severe allergic reaction that can kill within minutes. This guide covers ordinary sting first aid, how to recognise an emergency, and what beekeepers should think about in advance. This is general information, not medical advice. If you are worried about a reaction, contact a doctor or emergency services.

Removing a honey bee sting

A honey bee's sting is barbed and usually stays in the skin with the venom sac attached, which keeps pumping venom for a short time. Get it out quickly.

Scrape it out sideways with a fingernail, the edge of a bank card or a hive tool.
Do it fast. Speed matters more than technique.
Avoid squeezing the sac. Health advice generally recommends against pinching it with fingers or tweezers, which may push more venom in.

In the apiary, also smoke the sting site: the sting releases an alarm scent that can draw more bees to the same spot.

First aid for a normal sting

Wash the area with soap and water.
Apply a cold compress or ice pack wrapped in a cloth for about 20 minutes.
Raise the affected limb if you can.
Avoid scratching, which can lead to infection.
A pharmacist can advise on painkillers, antihistamines or creams.
Remove rings and watches near the sting before swelling sets in.

Normal and large local reactions

Normal: pain, redness and a swollen lump around the sting, settling over hours to a few days.
Large local reaction: swelling that spreads widely around the sting, for example an entire forearm, often peaking after a day or two. It is uncomfortable but not in itself dangerous. See a doctor or pharmacist if it worries you, or if it shows signs of infection such as increasing redness, warmth, pus or fever.

Anaphylaxis: call emergency services

Call 999 in the UK, 911 in the US, or your local emergency number, straight away if after a sting someone has any of these:

Difficulty breathing, wheezing, noisy breathing or a tight throat
Swelling of the lips, tongue, mouth or throat
Feeling faint, dizzy or confused, or collapsing
Pale, clammy skin or a fast heartbeat
A rapidly spreading rash or hives away from the sting, together with any of the above
Being stung in the mouth or throat

Severe reactions usually begin quickly, most often within minutes and generally within half an hour.

What to do while you wait

Call emergency services and say the person may have anaphylaxis.
If they have an adrenaline auto-injector, use it immediately, following the instructions on it. Do not wait to see whether symptoms get better.
Lie them down with their legs raised. If they are struggling to breathe, help them sit up instead.
Do not make them stand or walk, even if they feel better.
If symptoms do not improve after about 5 minutes and a second auto-injector is available, give it.
If they stop breathing, start CPR.

Anyone who has had adrenaline needs hospital assessment, even if they recover quickly, as symptoms can return.

Many stings at once

Large numbers of stings can cause a dangerous reaction even in someone who is not allergic. Get away from the bees, ideally indoors or into a car, and seek urgent medical help.

For beekeepers and their households

If you have ever had symptoms beyond the sting site, talk to your doctor before keeping or handling bees. Allergy specialists can test for venom allergy and, for some people, offer immunotherapy (desensitisation).
Anyone who has been prescribed adrenaline auto-injectors should carry them every time, check the expiry dates, and make sure others know how to use them.
Do not visit the apiary alone if you have any doubt; keep a phone with you and tell someone where you are.
Wear a veil at every inspection, and a full suit while you are learning.
Think about family members, visitors and neighbours, especially children.

Reactions can change over time: someone who has been stung many times without trouble can still develop an allergy, so take any new symptoms seriously. How do you handle stings in your apiary, and what protective kit works for you? Share your experience and questions in the comments.