HymenopteraEnvenomation: Bees, Wasps, And Ants

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Imagine these scenarios:

Paramedics call your emergency department to inform you that they are transporting a 12-year-old boy who was stung several hundred times by a swarm of honeybees. The patient is agitated and has innumerable erythematous papular stings to his face and extremities. What are your immediate priorities, and what are your subsequent concerns for delayed toxicity?

A 7-year-old girl is brought to triage by her parents after she was stung a single time by a wasp. She is lethargic with facial swelling and a generalized urticarial rash. In addition, she has respiratory distress with bilateral wheezes on lung examination, and pulse oximetry demonstrates oxygen saturations of 87% on room air. How should this life-threatening situation be managed?

A 2-year-old male is transported to your emergency department after stumbling into a fire ant nest. He is crying, irritable, and tachycardic but has no respiratory distress. He has multiple erythematous papules on his legs that are beginning to form fluid-filled vesicles. What is the treatment for this envenomation?

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