More severe and longer-lasting reactions often occur among those who have previously been stung by a honey bee. It is unknown how many honey bee stings occur each year however, the majority of victims only experience local symptoms, which include a raised erythematous area (wheal) that lasts for about 20 minutes accompanied by pain, itching, and swelling. Honey bee envenomation can result in mortality in rare cases due to both allergic anaphylaxis and massive systemic envenomation. The enzyme phospholipase A 2 is believed to be the most allergenic and immunogenic protein in honey bee venom, and it may trigger anaphylaxis in hypersensitive individuals. Honey bee venom contains several active compounds that lead to pain and cellular injury, including the proteins melittin (a hemolytic factor, and approximately 50% of the venom dry weight) and apamin. They are found in large colonies and will sting to defend themselves or their nests such stings are a common cause of morbidity in many regions of the world. There are seven species of honey bees (order Hymenoptera, genus Apis) that exist worldwide they are essential for the pollination of plants, including many food crops, and may also be used for harvesting honey. Based on the available evidence, a retained honey bee stinger should be removed as quickly as possible, and there appears to be no disadvantage in doing it by pinching and pulling. The literature review was limited by the small number of studies on the topic, but both included studies include findings relevant to the clinical question of interest. The included articles used different methods and models to evaluate the relationship between venom injection over time, and one of these studies also compared different methods of stinger removal. The initial search identified 23 articles of interest following title and abstract screening, two studies met the inclusion criteria. We undertook a literature review to evaluate the evidence regarding the effectiveness and safety of methods of honey bee stinger removal. For some time, it has been proposed that a retained honey bee stinger should be scraped out by a dull edge, as opposed to pinching and pulling out the stinger, in order to minimize the volume of venom injected. Honey bee stingers have a uniquely designed venom sac with a piston-containing bifurcated stinger that can remain in human skin and continue injecting venom after stinging. Do not scratch the sting as this may increase swelling, itching, and risk of infection.Honey bee envenomations are a common occurrence and cause localized morbidity but rarely cause systemic symptoms or death in humans.Never squeeze the stinger or use tweezers.Remove the stinger using gauze wiped over the area or by scraping a fingernail over the area.Have someone stay with the worker to be sure that they do not have an allergic reaction.If a worker is stung by a bee, wasp, or hornet: Workers with a history of severe allergic reactions to insect bites or stings should consider carrying an epinephrine auto injector (EpiPen) and should wear a medical identification bracelet or necklace stating their allergy.If a bee comes inside your vehicle, stop the car slowly, and open all the windows.Some insects (particularly Africanized Honey Bees) are known to hover above the water, continuing to sting once you surface for air. If you are able to physically move out of the area, do not to attempt to jump into water.A shaded area is better than an open area to get away from the insects.(Bees release a chemical when they sting, which may attract other bees.) If you are attacked by several stinging insects at once, run to get away from them.(Swatting at an insect may cause it to sting.) Remain calm and still if a single stinging insect is flying around.Social wasps thrive in places where humans discard food. Wear clothing to cover as much of the body as possible.Avoid bananas and banana-scented toiletries.Avoid perfumed soaps, shampoos, and deodorants.Wear light-colored, smooth-finished clothing.Workers should take the following steps to prevent insect stings: Employer RecommendationsĮmployers should protect their workers from stinging insects by training them about: Geographic Regionīees, wasps, and hornets are found throughout the United States. Nests and hives may be found in trees, under roof eaves, or on equipment such as ladders. Bees, wasps, and hornets are most abundant in the warmer months.
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