Stung and Turning Red [Bee Sting and Anaphylaxis]
Stung and Turning Red [Bee Sting and Anaphylaxis]
Case #3
You're out for a walk in the woods with your friends.
One gets stung. It hurts and the area is a little red.
You all walk further up the trail. A few minutes pass.
He stops, says he's having trouble breathing, and his throat is scratchy.
You see his lips are swollen and he is making noise with each breath.
What do you do?
How It Hurts
Your body’s immune system defends it against foreign objects.
Sometimes it overreacts and hurts your own cells in the process.
This is an allergy.
Anaphylaxis is an allergy cranked up to 11. It is a potentially lethal allergic reaction.
Commonly, it causes:
Hives, a raised, usually itchy rash.
Facial or tongue swelling.
Shortness of breath.
Less commonly, it can also cause belly pain, vomiting, low blood pressure, chest pain, or passing out.
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What To Do
There are generics and other devices, but I’m going to say “EpiPen” to keep it simple.
Each pen contains a single adult dose of epinephrine.
Give it to the person by following the instructions on the pen itself.
Then get help, because the med can wear off.
If five minutes have gone by and the person isn’t feeling better, give the second pen.
This is an Epipen Jr.
The dose is for kids 10 to 25 kg, or 22 to 55 lbs.
Above 25 kg or 55 lbs, the 0.3mg autoinjector (the adult one) is recommended.
(source)
Don’t fuck it up
The company has a catchphrase, “blue to the sky, orange to the thigh".”
I doubt your adrenaline-dumping lizard brain can remember that when your friend is struggling to breathe in front of you.
They print instructions on each pen for a reason.
Follow the instructions, one step at a time. Nice and smooth.
Taking a few extra seconds to not mess it up isn’t likely to make a difference.
Wasting one of your two doses of epi will.
Pitfalls
Stabbing yourself in the finger because you panicked and didn’t follow the instructions.
Your finger will probably be fine; epinephrine is used in hand surgeries (albeit in much lower concentration)
Expect numbness, pain, and turning white for several hours.
Get help if it’s available, but only after you’ve taken care of the person who you were trying to help- they are the ones in immediate danger.
Looks like this. Giving other meds before/instead of epinephrine.
Benadryl, Pepcid, other antihistamines, steroids are adjuncts. They do not fix the problem.
Wrong.
Not giving it in the person’s thigh. Thigh has better blood flow compared to the arm. (source)
Thigh is yellow/orange line, arm is blue line. Y axis is epinephrine level in the blood. (source)
Not holding it in place 3 seconds after it clicks.
The injection takes three seconds to complete, as shown here with ballistic gel.
How To Prep For It
If you don’t have access to epinephrine, you’re probably fucked.
If you have had anaphylaxis, you should already be carrying an Epipen.
They are prescription only. Ask your doctor.
If you haven’t had it, but want one to carry “just in case”, it couldn’t hurt to ask.
If they say no, it’s out of caution.
Epinephrine can cause heart issues if given improperly, especially in older people or those with heart disease.
If you have loved ones who had anaphylaxis, everyone around them who is capable of helping should know where their Epipen is stored and be able to access it.
Have a backup. One in the house that doesn’t move, and one that goes with them
How To Practice
If you have a friend who has an Epipen kit, the kit comes with a trainer pen.
Local EMS/fire would probably let you play with the trainer for free if you ask nicely.
Naturally, they sell Epipen trainers on Amazon. (paid link)
Don’t let your first time doing it be in a real situation.
Practice.
Quiz
Anaphylaxis can cause which of the following symptoms:
Passing out
Itchy raised rash
Tongue swelling
Funny noises when breathing
All of the above
The best treatment for anaphylaxis is:
Diphenhydramine (Benadryl) by mouth
Ice
Epinephrine into a muscle
Famotidine (Pepcid) by mouth
Loperamide (Imodium) by mouth
Epinephrine autoinjectors should be given in the:
Shoulder muscle
Heart
Outer thigh
Back of the head
After giving an autoinjector, you should:
Get the person to medical attention
Continue what you were doing before because they feel better
Take home points
Anaphylaxis is a life-threatening allergic reaction.
Most of the time it causes hives, facial or mouth swelling, and breathing issues.
Epinephrine is the treatment.
If SHTF, you haven’t done it before, and you need to, slow down. Instructions are on the pen.
Find a way to practice with an autoinjector.
If you have had anaphylaxis before, you should already be carrying an Epipen.
Answer key
e
c
c.
Also wrong. a. The med can wear off and the person can need a second dose or even more.
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