Go to start page
V1.6.13 T363
Rb445240b7
Disclaimer & Information
Search
Show Mindmap
 
Poisonous animals
 
Cnidarians (Jellyfish, Corals and Anemones)
 
Venomous fish
 
Scorpions
 
Spiders
 
Hymenopterans (Bees, Wasps and Ants)
 
Sea snakes
 
Terrestrial snakes
 
Miscellaneous animals
 
 
 
 
 
 
 
 

Is the patient envenomed?

 

General problems

D  Diagnostics

Patient history with regard to pre-existing conditions and medications:

1. known Hymenoptera allergy?

2. coronary heart disease?

3. beta-blocker use?

 

How severe is the allergic reaction?

D  Diagnostics

Inquire re:

  • When did the sting(s) occur?

Assess:

  • state of consciousness.

Measure:

  • blood pressure/pulse,
  • breathing (respiratory rate).

Classification of allergic reactions (Müller 1988):
1. Local reaction:

  • local swelling (diameter: >10 cm?; duration: >24 h?).

2. Systemic reactions:

  • Grade I: generalised urticaria, pruritus, nausea, fear.
  • Grade II: grade I symptoms plus 2 or more of the following: angio-oedema (if this symptom appears in isolation, this is already a grade II reaction), a feeling of tightness in the throat or chest, vomiting, diarrhoea, abdominal cramps, dizziness.
  • Grade III: grade I and II symptoms plus 2 or more of the following: respiratory distress, rhonchi, stridor (if any of one of these symptoms appears in isolation, this is already a grade III reaction), dysphagia, dysarthria, hoarseness, weakness, drowsiness, fear of death.
  • Grade IV: grade I–III symptoms plus 2 or more of the following: fall in blood pressure, collapse, loss of consciousness, incontinence (urine, faeces), cyanosis.
  • Uncommon reactions: see Therapy phase: Hospital.

Are there multiple stings with the risk of a toxic course of envenoming?

D  Diagnostics

Inquire re:

  • When did the stings occur?

Assess:

  • state of consciousness.

Measure:

  • blood pressure/pulse,
  • breathing (respiratory rate).

Count: the number of stings (simultaneously removing any stings remaining in the skin according to first aid methods: see Therapy phase: First aid / lay people).

Classification with multiple stings: when toxic symptoms are present, it is likely that >50 stings have occurred.