What this protocol covers
The mosquito bite, wasp or bee sting or tick that reaches the counter: what relieves it, how to remove a sting or a tick, and which symptoms cannot wait.
1. What to ask
- What bit or stung them and when? Where is it?
- Is the reaction only at the site, or are there symptoms elsewhere in the body?
- Has it happened before? Do they have a known allergy to stings and carry adrenaline?
- Is the area getting redder and hotter, with red streaks, or do they have a fever?
- How old are they? Are they pregnant?
2. Refer if any of these appear
- Difficulty breathing, swelling of the lips, tongue or face, dizziness or hives all over the body: emergency services (999 or 112), and adrenaline if they carry it.
- A sting inside the mouth or in the throat.
- Many wasp or bee stings at once.
- Redness that spreads and gets hotter after 48 hours, red streaks or fever: it may be infected.
- After a tick, a red patch that keeps spreading or a fever in the following days or weeks.
3. If there are no red flags
A mild local reaction
- Wash with soap and water and apply something cold wrapped in a cloth.
- If it is very itchy, a low-potency topical corticosteroid (hydrocortisone) for a few days.
- If the itch stops them sleeping, an oral antihistamine.
Bee
- Remove the sting as soon as possible by scraping with the edge of a card, without squeezing the venom sac with tweezers.
Tick
- With fine-tipped tweezers, grip it as close to the skin as possible and pull straight out, without twisting.
- No oil, alcohol or heat before removing it. Afterwards, wash and keep an eye on the area for a few weeks.
4. Adjust to who will take it
- Children
- Cold and no scratching. In the youngest, ask before a corticosteroid or an antihistamine, and always choose forms and doses suited to their age.
- Pregnancy
- Cold; topical hydrocortisone on a small area for a few days. An oral antihistamine after asking.
- Long-term conditions
- A known allergy to stings: always carry the adrenaline auto-injector and use it at the first symptoms elsewhere in the body, without waiting.
What not to recommend
- Topical antihistamines: they can sensitise the skin and cause reactions in the sun.
- Home remedies such as ammonia or mud.
- Removing a tick by burning it or with oil.
- Scratching or bursting blisters.
What to say at the counter. Cold, no scratching and this cream for a few days if it itches a lot. But if you find it hard to breathe, your face swells or hives appear on your body, call the emergency number, not the pharmacy.
Pharmacy Pills · conveniodefarmacia.com
Patient sheet: insect bites and stings
To print and hand over. It carries only what the patient needs at home.
- Wash the area and apply something cold wrapped in a cloth.
- Do not scratch.
- Call the emergency number if you find it hard to breathe, your face or lips swell, you feel dizzy or hives appear all over your body.
- Get advice if the area is getting redder and hotter, you have a fever, or after a tick a patch appears that keeps spreading.
Self-assessment
Three questions. When you check your answers you will see the explanation for each one.
-
Swollen lips and difficulty breathing are a severe allergic reaction: an emergency.
-
Gripped close to the skin and pulled straight out, it comes out whole; oil or heat can make it regurgitate.
-
They can cause contact dermatitis and photosensitivity; if one is needed, an oral antihistamine is better.
Training content. It does not replace the summary of product characteristics or clinical judgement.