Insect Bites and Stings Patient and Family Education This teaching sheet contains general information only. Your child’s doctor or a member of your child’s health care team will talk with you about specific care for your child. What is a bite or sting? A bite or sting happens when bees, wasps, yellow jackets, hornets, fire ants or other insects place venom under the skin (Spider bites and tick bites are NOT covered by this teaching sheet). Usually there is a local reaction to the bite or sting. It can be quite large and may happen right away or during the next 12 hours. There can be two types of allergic reactions to a bite or sting: Local skin reactions Body reactions that can cause breathing or blood pressure problems What kind of skin reactions may occur? Your child may have one or more of these skin reactions: Swelling Pain Redness Itching around bite/sting or other skin areas Hives around the bite/sting or covering other skin areas Skin reactions are often uncomfortable, but are not dangerous. Even when widespread, these reactions usually do not mean your child is at risk for a serious reaction to future bites or stings. Talk with your child’s doctor to be sure. What are the symptoms of a serious reaction to a bite or sting? Call 911 or go to the nearest emergency room right away if he shows signs of a severe allergic reaction such as: Swelling in the mouth, eyes or face Tickle in the throat or tongue Trouble breathing such as wheezing or coughing Drooling or trouble swallowing Hoarseness Chest tightness Feeling faint or dizzy Sweating Stomachache or vomiting Also call 911 if your child has had a bite or sting on the tongue. In case of an urgent concern or emergency, call 911 or go to the nearest emergency department right away. Outpatient l PFEN 041 / 09.10 / Insect Bites and Stings Page 1 of 3 Insect Bites and Stings, continued If any of these serious symptoms occur: Talk to your child’s doctor about seeing an allergy specialist. Your child may need allergy shots, an epinepherine injection device or other ways to prevent symptoms. If your child has had a severe allergic reaction before, he must carry an epinepherine injection device with him at all times. What is the treatment of bites and stings? First aid treatment if your child has a known allergy to an insect bite or sting: If you have been shown how to use an epinepherine injection device for a known allergy, use it as prescribed by your child’s doctor. Then, call 911 or go to an Emergency Room right away. Some general guidelines for treating insect bites and stings may include: If you see a stinger, remove it. Use a credit card or driver's license to “flick” it off the skin. Do not pinch it. Wash the area with soap and water. If it comforts your child, apply ice to the area 3 times per day. - Each time put ice on for 20 minutes and off for 10 minutes during the first 12 to 24 hours to reduce swelling. - Do not apply ice directly to your child’s skin. Always wrap the ice pack with a towel or cloth. Cut fingernails short to prevent scratching the skin. If the bite or sting site is scratched open, apply an antibiotic ointment 2-3 times a day until healed. Apply a paste of meat tenderizer, baking soda or a wet tea bag for pain until the area feels better. Give an antihistamine such as Benadryl for the itching, as advised by your child's doctor. Acetaminophen (Tylenol, or less costly store brand) or ibuprofen (Motrin, Advil, or less costly store brand) may be given for pain. Follow the directions on the box carefully or ask your doctor how much medicine to give. - Do not give your child more than 5 doses of acetaminophen in a 24-hour period. - Do not give acetaminophen to babies less than 3 months of age without talking with your child's doctor. - Do not give ibuprofen to babies less than 6 months of age without talking with your child's doctor. How can I prevent bites and stings from occurring? Do not allow your child to walk barefoot. Teach your child to avoid playing by ant hills, bee nests, bushes, flowers, standing pools of water or near the garbage. Avoid flowered or brightly colored clothes, perfumes and hair sprays. Insects and bees are attracted to food and drinks. Use care when eating and drinking outdoors. This is especially true with open containers of sweet drinks. In case of an urgent concern or emergency, call 911 or go to the nearest emergency department right away. Outpatient l PFEN 041 / 09.10 / Insect Bites and Stings Page 2 of 3 Insect Bites and Stings, continued Using insect repellents for mosquitoes and fleas Use a children's insect repellent containing no more than 30 percent DEET for children over 2 months of age. - Apply the repellant to the outside of clothes and shoes. Do not apply to skin under clothing. Do not apply to your child’s hands. - To apply the repellant to your child’s face, spray it on your hands first. Then rub it on your child’s face. Avoid contact with the eyes and mouth. - Follow the label direction for when to re-apply the repellant. Do not use insect repellents on babies less than 2 months of age. Do not use a combination product that contains both sunscreen and insect repellant. When should I call the doctor? Call your child’s doctor right away if your child has a temperature over 100.3°F. Also call right away if the bite or sting site shows signs of infection such as: Increased swelling after 24 hours Increased redness or streaking after 24 hours Increased pain Cloudy drainage Bad smell from bite or sting site Also call if you have any questions or concerns about how your child looks or feels. In case of an urgent concern or emergency, call 911 or go to the nearest emergency department right away. Outpatient l PFEN 041 / 09.10 / Insect Bites and Stings Page 3 of 3