Yellow Jacket Sting Treatment

Yellow jackets are not the same as bees

yellow jacket wasp
mariusz_prusaczyk/istock

Yellow jackets are related to bees, but they are not the same by any means. They are both part of the family of species known as hymenoptera. Hymenoptera means “membranous wings” and includes, among other insects, bees, wasps, hornets, and yellow jackets.

For the purposes of sting treatment, the biggest difference between yellow jackets and bees is that yellow jackets can sting their targets multiple times. In fact, they have a reputation for being pretty aggressive, especially among gardeners. In case of a yellow jacket sting, there are first aid steps to take immediately and some strategies to help with pain and itching for the next few days.

Yellow Jacket Sting Treatment: Immediate Steps

Don't get stung any more. See the section below for ways to avoid getting stung in the first place. Remember, yellow jackets can sting multiple times, so you're not out of the woods just because you've been stung once.

  1. For large reactions, multiple stings, or known allergies:
      1. If the patient has a known allergy to wasps, bees, hornets, or yellow jackets, it is appropriate to call 911 immediately, especially for multiple stings.
    1. For large reactions and swelling, call 911 and treat with an epinephrine auto-injector, if available.
    2. Call 911 for any patient with shortness of breath, trouble swallowing, trouble speaking, or loss of consciousness.
    For small reactions:
      1. Wash the sting site with soap and water.
    1. Apply ice or heat to address pain and swelling. One study found that concentrated heat had very good success in wasp stings. Keep in mind, however, that the study was sponsored entirely by the maker of a heat device for insect stings.
    2. Apply topical antihistamine or calamine lotion.
    3. Take diphenhydramine for mild itching and swelling.

    Allergic Reactions

    The biggest fear in any bee or yellow jacket sting is of a severe allergic reaction. As much as 25 percent of the population can develop allergic reactions to yellow jacket stings. Up to 3.5 percent could develop anaphylaxis. Any patient who has had a significant reaction to a bee, wasp, or yellow jacket sting in the past should consider herself allergic and seek medical treatment for a sting.
    1. Allergic reactions can cause both local and systemic (all over the body) swelling and itching. Because local swelling can be severe even in relatively mild allergies, stings of the head and neck should be watched for the possibility of obstructing the airway and breathing.
    2. One of the most annoying things about mild (meaning non life-threatening) allergic reactions is the itch. Treating itching is the most important part for patients a few hours and days after a yellow jacket sting. The antihistamine diphenhydramine provides the best itch relief. It can be used topically or taken orally. Calamine lotion or hydrocortisone creams might also provide some relief.
    3. Anaphylaxis

      Severe, life-threatening allergic reactions (anaphylaxis) must be treated as emergencies. Call 911 and get professional medical help immediately.
    4. Signs and symptoms of anaphylaxis include:
      • Difficulty swallowing
  1. Shortness of breath
  2. Hives
  3. Redness on skin not directly near the sting
  4. Swelling not directly near the sting
  5. Itching not directly near the sting
  6. Dizziness
  7. Confusion
  8. Low blood pressure
  9. Rapid pulse
  10. Using Epinephrine

    Anaphylaxis patients with access to epinephrine should not hesitate to use it. In most cases, epinephrine is delivered through an auto-injector that the patient can self-administer. Auto-injectors vary slightly by brand, but the concept is the same:
      1. Arm the device, usually by removing a safety cap.
    1. Firmly press the auto-injectors into the outside surface of the thigh and hold it there for at least 10 seconds. A small needle will insert into the thigh and automatically inject the medication.
    It seems almost cruel that the treatment for a severe allergy to yellow jacket stings is to sting yourself with an even bigger needle, but withholding the treatment even for a few minutes could lead to the patient becoming incapacitated and unable to self-administer. It's vitally important to use an epinephrine auto-injector if the patient is aware that he is allergic to bees or wasps.
    1. Home Remedies

      The internet is full of home remedies for all sorts of ailments, and yellow jacket stings are no different. One popular option advises a paste of water and baking soda applied to the site of the sting to relieve swelling and itching. The idea is that the venom is acidic and the baking soda will help it.
    2. Almost as popular is the use of vinegar to treat the itching. Some sites suggest both at the same time. If, indeed, the benefit is based on the pH of the venom, it makes little sense to use both an acid and a base to treat the same sting.
    3. Other than honorable mentions in some physician-directed advisory guidelines, there is no evidence to support the use of vinegar or baking soda for yellow jacket stings. Stick with the pharmaceuticals.
    4. Yellow Jackets or Bees: What's the Difference?

      There are plenty of bees with black and yellow coloring. Considering that yellow jackets are called yellow jackets because of their coloration, it stands to reason that they could get confused. Yellow jackets are more closely related to wasps than bees.
    5. The biggest visual difference between yellow jackets and bees is that yellow jackets are slim and smooth while bees are fat and hairy. Yellow jackets are meat-eating predators while bees are flower-loving, nectar-eaters.
    6. Hospitalization and Ongoing Medical Treatment

      Severe yellow jacket stings that must be treated at the emergency department will most likely be admitted to the hospital overnight. Treatment in the hospital could include administration of epinephrine, intravenous fluids, antihistamines, steroids, and antivenom.
    7. In the event of severe allergic reaction, some patients will receive specific immunotherapy treatment. This is a small amount of wasp or bee venom given to the patient at regular intervals. This inoculates the patient against further allergic reactions in the even of another yellow jacket sting.
    8. Avoid the Sting

      The best way to treat a yellow jacket sting is to avoid the sting altogether. Yellow jackets are similar to wasps and can be very aggressive. Since they are predators and carrion scavengers, they like protein and will happily take a bite out of a picnic lunch. They also like sugar and will also sample sweets.
    9. Moral of the story: Don't take honey-glazed ham to the park.
    10. Yellow jackets don't want to sting humans any more than we want them to, but they will defend their nests if necessary. Yellow jackets live in the ground or under rocks and very much do not like to be disturbed. There are plenty of examples of yellow jackets chasing interlopers from their nests, stinging all the way.
    11. Sudden movements are more likely to stimulate them to attack. When a yellow jacket feels threatened, it emits a pheromone that calls other yellow jackets to its defense. When you find yourself face to face with a yellow jacket, back away slowly.
    12. Using pesticides or not is up to you, but don't mess with a yellow jacket nest unless you are prepared to kill them. They will aggressively defend their homes. And next year, their home will be in a different place. Yellow jackets, like other wasps, build new homes every spring.
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