Wasp sting

Wasp venom is toxic. It is injected into you when you are stung.

Wasps carry this venom. Some people are allergic to the venom and have a serious reaction if they are stung. Most people do not need emergency medical treatment if they are stung.

Below are symptoms of a wasp sting in different parts of the body.

EYES, EARS, NOSE, AND THROAT

• Swelling of throat, lips, tongue, and mouth *

HEART AND BLOOD VESSELS

• Rapid heart rate
• Severe decrease in blood pressure
• Collapse (shock) *

LUNGS

• Difficulty breathing *

SKIN

• Hives *
• Itching
• Swelling and pain at site of sting

STOMACH AND INTESTINES

• Abdominal cramping
• Diarrhea
• Nausea and vomiting

Note: The symptoms marked with an asterisk (*) are from an allergic reaction to the venom, not from the venom itself.

For severe reactions:

Call 911 or the local emergency number if the person has an allergic reaction (severe swelling or difficulty breathing). You may need to go to the hospital if the reaction is severe.

If you have an allergy to wasp, bee, hornet or yellow jacket stings, always carry a bee sting kit and know how to use it. These kits require a prescription. They contain a medicine called epinephrine, which you should take right away if you get a wasp sting.

To treat the wasp sting:

• Try to remove the stinger from the skin (if it is still present). To do this, carefully scrape the back of a knife or other thin, blunt, straight-edged object (like a credit card) across the stinger if the person can keep still and it is safe to do so. Or, you can pull out the stinger with tweezers or your fingers. If you do this, do not pinch the venom sac at the end of the stinger. If this sac is broken, more venom will be released.
• Clean the area thoroughly with soap and water.
• Place ice (wrapped in a clean cloth) on the site of the sting for 10 minutes and then off for 10 minutes. Repeat this process. If the person has problems with blood circulation, decrease the time that the ice is on the area to prevent possible skin damage.
• Keep the affected area still, if possible, to prevent the venom from spreading.
• Loosen clothing and remove rings and other tight jewelry.
• Give the person diphenhydramine (Benadryl and other brands) by mouth if they can swallow. This antihistamine drug may be used alone for mild symptoms.

Have this information ready:

• Person's age, weight, and condition
• Type of insect
• Time the sting occurred
• Location of the sting

Your local poison control center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. This national hotline will let you talk to experts in poisoning. They will give you further instructions.

This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.

If an emergency room visit is necessary, the health care provider will measure and monitor the person's vital signs, including temperature, pulse, breathing rate, and blood pressure. Symptoms will be treated. The person may also receive:

• Blood and urine tests.
• Breathing support, including oxygen. Severe allergic reactions may require a tube down the throat and breathing machine (ventilator).
• Chest x-ray.
• ECG (electrocardiogram, or heart tracing).
• Intravenous fluids (IV, through a vein).
• Medicines to treat symptoms.

How well a person does depends on how allergic they are to the insect sting and how quickly they receive treatment. The faster they get medical help, the better the chance for recovery. The chances of future total body reactions increase when local reactions become increasingly severe.

People who are not allergic to wasps, bees, hornets or yellow jackets usually get better within 1 week.

DO NOT put your hands or feet in nests or hives or other preferred hiding places. Avoid wearing bright colored clothing and perfumes or other fragrances if you will be in an area where wasps are known to congregate.

Curtis AM, Erickson TB. Venomous animal injuries. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 53.

Elston DM. Bites and stings. In: Bolognia JL, Schaffer JV, Cerroni L, eds. Dermatology. 4th ed. Philadelphia, PA: Elsevier; 2018:chap 85.

Erickson TB, Marquez A. Arthropod envenomation and parasitism. In: Auerbach PS, Cushing TA, Harris NS, eds. Auerbach's Wilderness Medicine. 7th ed. Philadelphia, PA: Elsevier; 2017:chap 41.

Hamill MB. Mechanical injury. In: Mannis MJ, Holland EJ, eds. Cornea. 5th ed. Philadelphia, PA: Elsevier; 2022:chap 94.

Updated by: Jesse Borke, MD, CPE, FAAEM, FACEP, Attending Physician at Kaiser Permanente, Orange County, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.