Insect Venom Allergy: Diagnosis & First Aid

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Insect Venom Allergy: Diagnosis & First Aid
Insect Venom Allergy: Diagnosis & First Aid
Video: Insect Venom Allergy: Diagnosis & First Aid
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Insect venom allergy: diagnosis & first aid

Depending on the severity, a distinction is made between local (local) reactions and general reactions (systemic reactions). With the latter there are complaints that have no local connection with the sting point. In an emergency, rapid first aid is important …

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  • Local reactions
  • Systemic immediate type reaction (anaphylaxis)
  • First aid and self-help measures
  • Skin and laboratory tests
  • Whom can I ask?

Local reactions

A distinction is made between local reactions:

  • Normal local reaction: The poison released by an insect bite leads to painful redness and swellings at the bite site, which are usually less than ten centimeters in diameter and clearly subside within a day.
  • Increased local reaction: The redness and swellings are more than ten centimeters in diameter, persist for more than 24 hours, are usually painful and can cause non-infectious inflammation of the lymph vessels. Mild general complaints such as feeling sick or shivering may occur.

In the case of stitches in the mouth and throat or in the upper airways, local swelling can sometimes lead to a threatening narrowing of the airways.

Systemic immediate type reaction (anaphylaxis)

Anaphylaxis is the most severe form of insect venom hypersensitivity and is usually caused by a single sting. General allergic reactions often occur without any noticeable reactions at the injection site. Anaphylactic reactions are incalculable and usually strike the patient completely unexpectedly. The reaction is triggered by IgE antibodies that are directed against components of the poison. Symptoms appear within seconds to a few minutes after the sting. They range from exclusive skin reactions (itching, reddening of the skin, hives and swellings) to mild to moderate complaints in the respiratory tract, gastrointestinal tract and cardiovascular system to potentially life-threatening conditions. These include narrowing of the airways,anaphylactic shock (often with loss of consciousness) and cardiovascular / respiratory arrest.

The characteristic complaints include:

  • Itching on the palms of the hands, soles of the feet or hairy parts of the body,
  • severe itching and redness all over the body,
  • Hives,
  • Swelling of the face and neck,
  • Runny nose and difficult nasal breathing,
  • itchy, reddened and watery eyes,
  • Dizziness and palpitations,
  • Nausea (up to vomiting), abdominal cramps,
  • Difficulty swallowing and speaking,
  • Cough, hoarseness, shortness of breath or feeling of choking
  • general feeling of weakness, powerlessness,
  • Collapse,
  • Unconsciousness,
  • Fear of death,
  • Respiratory and cardiac arrest.

First aid and self-help measures

First aid and self-help measures for allergy sufferers after an insect bite:

  • If necessary, remove stuck stings as quickly as possible. Caution: To avoid squeezing out the poison sac, do not squeeze the prickle device with your fingers or tweezers, but scrape it away with a fingernail.
  • Take emergency medication immediately if necessary.
  • Immediate cooling can reduce swelling.
  • Keep Calm.
  • Inform people in the area about the insect bite and possible consequences.

Always carry the emergency kit with you

People with known insect venom allergy should always have the emergency kit recommended by a doctor with them. Important: Always check the expiry date! Furthermore, allergy sufferers should have the doctor explain the handling of emergency medication to them in detail so that they can use them safely if necessary. The emergency kit consists of the following drugs:

  • Rapidly effective antihistamine: Has a decongestant effect, is also used, for example, to treat hay fever.
  • Cortisone preparation: also has a decongestant effect and dampens the acute reaction of the immune system.

Note These medications do not work immediately and should therefore be taken immediately after the bite without waiting for an allergic reaction.

An adrenaline pre-filled syringe: This is used as the most important emergency medication when the reaction goes beyond the local puncture site, e.g. swelling of the larynx, dizziness, nausea, tightness in the chest area, shortness of breath, etc. If blood pressure drops, adrenaline constricts the vessels in a matter of minutes and thereby stabilizes blood pressure and circulation. In addition, it improves breathing by widening the bronchi and dampens allergic reactions. In the event of a severe allergic reaction, the timely administration of adrenaline can be life-saving. Since these pre-filled syringes are rarely used and correct use is quickly forgotten even after good training, this must be practiced regularly. Videos provided by the Austrian Lung Union patient self-help group help

Note Anyone who suffers from asthma or other chronic illnesses should inform their doctor. In this case, the emergency kit must be supplemented individually.

Severe reactions almost always occur within the first 15 minutes after the insect bite. If there is more than one skin reaction at the puncture site (reddening / swelling) during this time, the emergency doctor should be informed immediately (emergency number Austria 144). First aid measures should also be initiated.

Skin and laboratory tests

In the doctor-patient conversation (anamnesis) it is clarified in which intensity which symptoms occurred and which insect species is responsible. The person concerned can usually state that a bee or wasp triggered the reaction, but it is often difficult to differentiate between bee and wasp. Here are some distinguishing features: Bees mostly only sting when they feel threatened, i.e. near beehives or flowers or when stepped on them (especially in clover meadows). The sting is stuck with the poison sack. Wasps are much more aggressive. They sting near food or rubbish, mostly while flying past. The sting is not stuck. Season: Bees sting all year round, wasps mostly in late summer / autumn.

The anamnesis is followed by a skin test (prick test, intracutaneous test) and a laboratory test. The blood is examined for allergy-specific antibodies (IgE). If no clear diagnosis can be made with this, further examinations can be carried out.

Whom can I ask?

If symptoms occur after an insect bite that go beyond a local skin reaction, this should definitely be discussed with a doctor. After the confirmed specialist diagnosis, the person affected is provided with an emergency kit for self-treatment in the event of a new sting, if necessary. If symptoms go beyond the skin, a further specialist allergological diagnosis is necessary in any case. Family, friends and acquaintances should be informed about the allergy and emergency measures.

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