Insect stings – and when they become an emergency
Most wasp and bee stings are painful but harmless: remove a bee sting quickly, cool the site and watch it. An emergency is a sting in the mouth or throat, because the swelling can block the airway, and any allergic reaction with breathlessness, facial swelling, dizziness or a rash all over the body: call the emergency number at once (112 in the EU, in Austria also 144). This text does not replace a first-aid course.
- A few minutes; then observe
Explained simply
A wasp or bee sting hurts, turns red and swells. Usually it is over after a few hours or days. If a bee sting is still in the skin, you scrape it out quickly. Then you cool the spot with a cold, wet cloth.
But there are two cases in which a sting becomes dangerous. First: the sting is in the mouth or throat. Then the swelling can make breathing difficult. Second: the whole body reacts allergically – with breathlessness, a swollen face, dizziness or a rash everywhere. In both cases call the emergency number at once (112 in the EU, in Austria also 144).
After a sting, stay near the person and watch them for a while. This text does not replace a first-aid course.
How it works
With a sting, the insect injects venom into the skin. The body reacts at that spot with pain, redness, swelling and itching. Bees often leave their sting behind with its venom sac, which can keep releasing venom – so it is removed quickly, however you can.
In some people not only the skin reacts but the whole body: vessels widen, mucous membranes swell, the circulation can fail. This is called a severe allergic reaction or anaphylaxis. It can develop within minutes.
What really matters
After every sting, watch for warning signs: breathlessness, hoarseness, swelling of the face, lips or tongue, dizziness, nausea, vomiting or a rash all over the body. Each of these is a reason to call the emergency number. Do not leave the person alone or let them walk around.
With a sting in the mouth or throat, also call the emergency number. Until help arrives, cool the neck from outside with cold compresses and – if the person is alert and can swallow safely – let them suck ice cubes.
Safety and limits
People with a known insect venom allergy often have an emergency kit prescribed by a doctor. You help them use it as it was explained to them – more in the emergency situation on a severe allergic reaction after a sting. This entry deliberately names no medication or dosages.
Many stings at once, especially in children, need a medical check. If a sting site becomes redder, hotter and more painful over the following days, it may have become infected.
Prevention
Outdoors, cover drinks and drink from glasses or with a straw – wasps like to crawl unnoticed into cans. Do not leave sweet food standing open, do not walk barefoot across clover or flower meadows and stay calm when a wasp is nearby.
Anyone who knows they are allergic always carries their emergency kit, and their companions know where it is. A cold pack in the first-aid kit is handy in summer.
Step by step
- 1
Move away from the insects
Calmly move away from the nest or swarm; do not flail.
- 2
Remove the sting
If a bee sting is stuck in the skin, quickly scrape it out sideways with a fingernail or a card or remove it with tweezers. Speed matters more than the method.
- 3
Watch for warning signs
Was the person stung in the mouth or throat? Are there breathlessness, hoarseness, facial swelling, dizziness, nausea or a rash all over the body? Then call the emergency number at once.
- 4
Cool
With a local reaction, cool the site with a cold, wet cloth or a cold pack wrapped in a cloth. Remove rings from a stung hand early.
- 5
Observe
Do not leave the person alone for a while and keep watching, especially after a first sting in children or with a known allergy. Allergic reactions can develop rapidly.
Common mistakes
- Dismissing breathlessness or facial swelling as a "normal reaction"
- Waiting with a sting in the mouth
- Leaving the bee sting in the skin
- Putting ice directly on the skin
- Leaving a person with an allergic reaction alone or letting them walk around
Quick view
Materials
Ice packs
Wrapped in a cloth
Do not fill water bottles to the brim for freezing – water expands as it freezes.
Cotton cloth / T-shirt
Cold, wet cloth for cooling
Removes coarse particles only – no disinfection.
First-aid kit (household)
Does not replace a first-aid course; check contents and expiry dates regularly.
Suitable for
- Single wasp, bee, bumblebee or hornet stings on the arms, legs or trunk
- Picnics, the garden, hiking, the playground
Not suitable for
- Waiting out or self-treating allergic reactions – that is an emergency
- Many stings at once, especially in children – then medical help or the emergency number
Prerequisites
- Knowing whether the stung person has a known insect venom allergy
- Knowing the emergency number
Safety
- This text does not replace a first-aid course. First aid is learned through hands-on practice under instruction. In an emergency always call professional help – via the local emergency number (112 in the EU) – and follow the dispatcher's instructions.
- Do not scratch. If the site becomes increasingly red, hot or painful over the following days, or fever develops, have it checked by a doctor.
How it works
With a sting, insect venom enters the skin. In most people this only causes a local reaction: pain, redness, swelling and itching that fade after hours to a few days. Bees often leave their sting with its venom sac in the skin, and the sac can keep releasing venom – so it is removed quickly. A sting becomes dangerous when the swelling narrows the airway (mouth, throat) or when the whole body reacts allergically. Then there is little time, and professional help must come at once.
Advantages
- Simple measures for most stings
- Recognising warning signs early saves lives
Disadvantages
- Allergic reactions are not predictable and can occur even without a known allergy
Deep knowledge
Background
The ERC first-aid guidelines describe anaphylaxis as a life-threatening allergic reaction in which bystanders should call the emergency number at once and help the person use their own emergency medication. The guideline of the European Academy of Allergy and Clinical Immunology (EAACI) names insect stings as one of the common triggers in adults.
Stings in the mouth often happen when a wasp has crawled unnoticed into a drink. That is why it is worth checking cans and cups outdoors.
Variants
- Severe allergic reaction
- For the detailed procedure for a severe allergic reaction after a sting – emergency call, helping with the person's own emergency kit, positioning – this site has a separate emergency situation, "A severe allergic reaction after a wasp or bee sting outdoors".
- Prevention
- Outdoors, cover drinks and drink from glasses or with a straw, do not leave sweet food standing open, and do not walk barefoot across clover or flower meadows. Anyone with a known insect venom allergy should always carry the emergency kit their doctor prescribed.
Common mistakes
- Dismissing breathlessness or facial swelling as a "normal reaction"
- Waiting with a sting in the mouth
- Leaving the bee sting in the skin
- Putting ice directly on the skin
- Leaving a person with an allergic reaction alone or letting them walk around
Limits and risks
- Does not replace a first-aid course
- No medication recommendations or dosages
- Emergency kits prescribed by a doctor only as instructed to that person
Sources
European Resuscitation Council – Resuscitation (journal) (2021): European Resuscitation Council Guidelines 2021: First Aid
Recognising anaphylaxis, emergency call, helping with own emergency medication
Allergy 77(2): 357–377 (A. Muraro et al., European Academy of Allergy and Clinical Immunology) (2022): EAACI guidelines: Anaphylaxis (2021 update)
Insect stings as a trigger and signs of anaphylaxis
Deutsches Rotes Kreuz (DRK): Erste Hilfe – Informationen und Kurse
Sting in the mouth and throat: emergency call, cool from outside, suck ice