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How is a severe allergic reaction immediately treated?
Honeybee stingers are barbed stingers that are left behind in the person's skin after the initial sting. If the stinger is removed by pinching the stinger, more venom is actually injected into the skin. It is better to remove the stinger by gently lifting the stinger using a fingernail or knife edge to flick the stinger out of the skin. Other stinging insects do not leave stingers behind and this technique does not apply.
An allergic reaction is treated with epinephrine (adrenaline). Several self-injectable devices are available by prescription, including Epi-Pen, Auvi-Q, and others. These devices are filled with the epinephrine to be injected in to the subcutaneous tissue or muscle, preferably into the front of the thigh. These self-injected devices usually contain only one dose and, on occasion, more than one dose is needed. Venom extractors are commercially available, but they have not been demonstrated to have any benefit.
If a serious sting reaction occurs, always seek medical attention, even if epinephrine is used and all seems stable. The allergic reaction can subsequently progress and become more serious after epinephrine has worn off. Sometimes epinephrine is not enough and intravenous fluids or other treatment is needed. If you are known to be seriously allergic to insects, you must remember to carry the epinephrine at all times especially when out of reach of medical care (such as in the woods or even on an airplane). If epinephrine is not available when you are stung, contact a doctor as soon as possible. In addition to epinephrine, an oral dose of antihistamine (like Benadryl) can reduce the symptoms of an allergic reaction. Antihistamines take effect in about one hour. Ultimately, however, it is crucial to attempt to avoid the sting.