When a honeybee stings, it leaves behind a barbed stinger attached to a tiny venom sac embedded in the skin. The stinger apparatus is designed to remain in the victim. The musculature of the detached venom sac continues to contract automatically, acting as a pump to inject venom into the tissue. Since this process delivers a continuous dose of toxins, the primary goal of first aid is the quick and safe removal of the stinger apparatus.
Immediate Action and Identification
The first step after a sting is to calmly move away from the area to prevent additional stings. It is important to confirm if a stinger is present, as only honeybees leave their barbed stinger and venom sac behind, resulting in the bee’s death. Wasps, hornets, and yellow jackets have smooth stingers, allowing them to sting multiple times without detaching the apparatus. If no stinger is visible, immediate removal is unnecessary. A honeybee sting typically presents as a small black dot with a whitish venom sac pulsating on or just beneath the skin’s surface.
The Preferred Removal Technique
The method used to remove the stinger directly impacts the amount of venom delivered. Because the venom sac is present, any pressure applied to the stinger can squeeze the remaining venom into the wound. Therefore, pulling the stinger with tweezers or pinching it with fingers is strongly discouraged, as this maximizes the toxin dose.
The preferred technique is to scrape or flick the stinger out using a firm, blunt edge, such as a credit card, dull butter knife, or fingernail. Draw the edge across the skin in a sweeping movement, parallel to the surface, to dislodge the stinger without compressing the venom sac. Speed is important, as studies show up to 90% of the venom can be injected within the first minute. Removing the stinger quickly, regardless of the method, is more effective than delaying removal while searching for a perfect tool.
Post-Removal Wound Care
After removing the stinger, address the localized pain and inflammation. Clean the area thoroughly with mild soap and water to reduce the risk of bacterial infection. Applying a cold compress or ice pack helps constrict blood vessels, reducing both swelling and pain. Apply this cold therapy for about 10 to 20 minutes at a time.
Over-the-counter medications can manage mild symptoms. A nonsteroidal anti-inflammatory drug (NSAID) like ibuprofen or acetaminophen can help alleviate discomfort and generalized inflammation. Topical creams, such as hydrocortisone or calamine lotion, may be applied to reduce redness and itching.
Recognizing Severe Reactions
While most bee stings result only in minor local discomfort, a small percentage of people experience a life-threatening allergic reaction known as anaphylaxis. This systemic reaction requires immediate emergency medical attention. Symptoms indicating a severe reaction often occur rapidly and may include widespread hives or itching that spreads away from the sting site. Respiratory distress is a major concern, often presenting as wheezing, difficulty breathing, or swelling of the tongue and throat.
Other severe indicators are dizziness, a rapid or weak pulse, nausea, vomiting, or a sudden drop in blood pressure that can lead to fainting. If a person with a known bee venom allergy has an epinephrine auto-injector, such as an EpiPen, it must be administered without delay. After using the auto-injector, or if the person shows any of these severe signs, emergency medical services should be contacted immediately.