2 English reference bee sting [national guide to clinical application of essential drugs: 20 12 edition. Chemicals and biological products]
Bee sting [Chinese medicine terminology Committee] Terminology of traditional Chinese medicine (20 13)]
3 Summary Bee sting refers to an acute toxic disease that shows local redness and tingling, even dizziness and nausea when bee venom is injected into human body or left in skin with thorns [1].
Bee sting means that after being stung by wasps and bees, redness and pain usually appear only in the stung part, and it can disappear by itself after a few hours. If stung by swarms of bees, symptoms such as dizziness, nausea and vomiting may occur, and in severe cases, shock, coma and even death may occur [2].
After being stung by a bee, if there are damaged bee stings in the wound, you can pick them out with a sterilized needle or a small blade.
The wasp venom is alkaline, and the wound can be washed with acidic substances such as vinegar, 3% boric acid and 1% acetic acid to neutralize the venom. The venom of bees is acidic, and the wound can be cleaned with soda water, ammonia water, soapy water and alkaline water. Severe patients with systemic symptoms should go to the hospital for treatment.
Bee stings are mainly prevention. Pay attention to protect the exposed part when working in the field [2].
After being stung by swarms of bees, patients may be accompanied by systemic symptoms, such as shock or renal failure. It is suggested to transfer to a tertiary general hospital or a specialized hospital as soon as possible after symptomatic treatment [2].
About bees bees belong to Insecta, Hymenoptera. There are many kinds of bees, and the common stinging bees are wasps (also known as wasps or wasps), bees, ant bees, thin-waist bees and pill bees. Bees have stings and poisonous glands in their tails. Hornets often nest in forests, caves or under the eaves outside the family room. They like to live in groups and often fly in groups. For example, when walking, working or teasing the hive in the forest where bees live, wasps often swarm in groups and sting exposed skin.
5 Pathophysiology The stinger of the bee tail is connected with the venom gland in the rear part of the bee body. When a bee stings, the stinger pierces the skin, and then the venom is injected into the skin. According to different kinds of bees, the components of their venom are not exactly the same. For example, there are two kinds of venom secreted by bees: one is acidic venom secreted by large secretory glands, and its main components are formic acid, hydrochloric acid and orthophosphoric acid; The other is alkaline toxic juice secreted by small secretory glands, which contains neurotoxicity. Both viruses contain mediators and antigenic substances. It is determined that the venom of bees contains histamine. The venom of wasps is more toxic. Besides histamine, it also contains 5- hydroxytryptamine, cholinesterase, bradykinin, hyaluronidase and formic acid, so the venom released after piercing the skin can cause serious systemic allergic reactions.
Drones are non-toxic and do not sting. Female bees have stings and poison sacs at the tail, which are developed from ovipositor tubes and used for spawning and self-defense, but degenerate after mating and lose their stinging function. Worker bees sting people, the stinger at the tail is tubular, and the barb at the top is connected with the poison sac. When stinging people, the sting often penetrates deeper and deeper into the skin, and when leaving the skin, the sting often breaks in the skin.
6 Symptoms and signs Immediately after being stabbed, the skin feels itchy and tingling. Soon, local redness, wheal or blisters appeared. There is a bruise in the center of the stung wound. If you are stung in many places, you can produce significant edema and severe pain in a large area. If you get stung around your eyes, your eyelids will be highly swollen If the lips are stung, the mouth can be obviously swollen or accompanied by systemic wheal. In severe cases, besides local symptoms, there are different degrees of systemic symptoms, such as chills, fever, dizziness, headache, nausea, vomiting, palpitations, irritability or convulsions, pulmonary edema, collapse, coma or shock, and often die within hours or days. Therefore, once a bee sting with systemic symptoms occurs, it must be treated as soon as possible. There have been several cases of allergic shock death caused by bee sting in China, and there are also cases of renal failure caused by hemoglobinuria caused by bee sting.
The diagnosis of bee sting has a history of bee sting, which may or may not be accompanied by systemic symptoms. In severe cases, shock or acute renal failure may occur [2].
According to the history of bee sting, local pain and obvious swelling symptoms, it is generally not difficult to diagnose. But it should be differentiated from other insect bite dermatitis.
8 Treatment of bee sting 8. 1 First aid measures (1) After being stung by a bee, its poisonous needle will remain in the skin. You must use a disinfection needle to remove the broken thorn in the meat, then hold the stung part hard and suck it repeatedly with your mouth to suck out the toxin. If there is no medicine around for the time being, wash the affected area with soapy water and then apply some vinegar or lemon juice.
(2) After being stung by a bee, in case of shock, after notifying the emergency center or on the way to the hospital, attention should be paid to keeping the injured person breathing smoothly, and emergency treatment such as artificial respiration and heart * * * should be carried out.
8.2 After the local treatment wound is stung by a bee, if there is a broken bee sting in the wound, it can be picked out with a sterilized needle or a small blade [2]. Then use a breast pump or cupping to suck out the poison. It is easy to break the sting in the skin after bee sting, but other bees generally don't break the sting.
External use 10% ammonia or insect bite dermatitis lotion, or cold wet compress with 5% ~ 10% sodium bicarbonate solution to relieve pain, or boil Ji Desheng snake slices into a thin paste and apply it to the skin lesions. Folk fresh amaranth or fresh Prunella vulgaris is pounded and applied to the affected area, which has good anti-inflammatory and analgesic effects.
Poison bee: After being stung by poisonous bees, it is basically ineffective to apply ammonia water to the affected area, because the histamine of bee venom cannot be neutralized by ammonia water.
Wasp: The venom of wasp is alkaline, and the wound can be washed with acidic substances such as vinegar, 3% boric acid and 1% acetic acid to neutralize the venom [2].
Bees: The venom of bees is acidic, and the wounds can be washed with soda water, ammonia water, soapy water and alkaline water [2].
Wasps are poisonous, but bees are not. After being stung by a bee, you should also pull out the broken thorn first. Unlike wasps, you can apply some ammonia, baking soda water or soapy water to the wound.
Those who are asymptomatic after being stung by bees for 20 minutes can rest assured.
8.3 Mild patients were injected with chlorpheniramine 10mg or promethazine 25 ~ 50m g[2].
If the pain is obvious, take 3 ml of emodin hydrochloride 1% water solution and add 2% lidocaine to inject subcutaneously near or around the sting, which can quickly relieve the pain and reduce swelling. If there is systemic reaction or obvious skin swelling and blisters, you can take antihistamines and corticosteroids orally, or take Ji Desheng snake tablets.
8.4 If severe shock patients have palpitation, collapse, dyspnea or shock symptoms, they should organize rescue in time.
See the article on anaphylactic shock for details.
8.5 Patients with severe treatment complications may have acute renal failure and can be given dialysis treatment [2].
9 Prognosis and prevention of bee stings Beekeepers should wear long-sleeved clothes, masks, gloves and shawls when collecting honey or working in wild forest areas to avoid bee stings. Don't chase bees when they are flying, in case they are provoked and stung. Teach children not to tease the hive, and find that the hive should be completely destroyed, eliminating wasps and larvae. Personal protection should be strengthened when destroying beehives.
10 special tips 1. First of all, we should pay attention to prevention and stay away from grass and bushes, because it is often the home of bees.
2, found that the hive to bypass, don't "close".
It is best to wear light and smooth clothes, because the visual system of bees is very sensitive to the movement of dark objects under light background.
If someone provokes the bee colony by mistake and is attacked, the only way is to protect his head and neck with clothes, run in the opposite direction or get down in the same place. Never try to fight back, otherwise it will only lead to more attacks.
5. If you have been stung by a bee, you can sting the bee with a needle or tweezers, but don't squeeze it to avoid the residual toxin entering the body. Then smear the stung part with soda water or even urine to neutralize the toxicity. You can apply a towel soaked in cold water to the wound to reduce swelling and relieve pain, and finally go to the hospital for treatment.
1 1 About mosquito bites Mosquito bites are the name of the disease, also known as insect sting dermatitis. Refers to the skin diseases such as rash and itching, which are mainly manifested by the bites of mosquitoes, bedbugs and fleas [1]. The clinical feature is that the skin is papular wheal with needle-like petechiae, papules or blisters, which are scattered.
"Authentic Surgery" says: "Evil insects go with yin and yang, such as centipedes, scorpion bees ... deliberately poisoning people ..."
See mosquito bites for details.
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