UNIVERSITY OF WISCONSIN MEDICAL FOUNDATION
CLINICAL POLICY AND PROCEDURE
TITLE: BEE STINGS & INSECT BITES
Effective Date: April, 2005 Approval: See Authorization
Supersedes Protocol: None Contact: Clinical Staff Education
Reviewed November 2007 May 2009 February 2012
PURPOSE: To provide guidelines for the assessment and treatment of bee stings and insect bites at UWMF
Insect Bite - a penetration of the skin by a bee sting or insect bite. Both can be serious, ranging from mild
irritation, itching and swelling to a systemic (anaphylactic) reaction.
Tolerance - a phenomenon by which the body becomes increasingly resistant to a drug or other substance
through continued and/or repeated exposure to the substance. Most stings/bites can cause pain and swelling.
Every time a person is affected, a greater tolerance or intolerance is created, depending upon the frequency of
exposure to the allergen. If a person is stung/bit frequently, the tolerance level remains high. This is why
beekeepers, who may be stung often, do not have severe reactions. The tolerance dissipates in roughly six
Intolerance - Extreme sensitivity or allergy to a drug, food, or other substance; exposure to the substance may
cause an adverse reaction. intolerance continues to build throughout one's lifetime and can lead to anaphylaxis.
POLICY: The clinical staff will utilize the following guidelines to assess and treat UWMF patients with bee
stings or insect bites. Bee stings and insect bites should be treated as a minor wound.
SUPPLIES: Prescribed antibiotic cream, soap and water, gauze, ice, patient’s record,
Tetanus status, tetanus vaccine (if indicated)
1. Wash hands and gather equipment.
2. Introduce yourself to the patient and identify the patient, to include date of birth. Verify patient
3. Assess for anaphylaxis - ABC’s → assess airway, breathing and circulation.
Refer to and follow Anaphylaxis Protocol (if anaphylactic in nature).
Record vital signs including BP, HR, RR and pulse oximetry (if available).
Obtain brief history (onset and symptoms, history of previous reactions).
4. Check with patient or the patient’s record for allergies as you explain procedure.
5. Asses the area of a bee sting for presence of the stinger. Look very carefully for a small black dot in the
center of the welt, it will look rather like a very tiny splinter. If stinger is present, remove it by gently
scraping it off using a hard object like a credit card.
6. Wash the area thoroughly with soap and water unless otherwise instructed.
7. Apply an antibiotic cream (unless allergic) to prevent infection and cover it with a clean dry bandage.
8. Apply ice to site.
9. Tetanus immunization will be given if indicated.
10. Document in the patient's record:
type of insect or bee and the location of the bite or sting
care given including medications or vaccination
patient education and discharge instructions
follow-up appointment (if needed)
patient's response to the procedure
11. Discharge instructions (unless otherwise instructed by provider)
Limit liquids, to decrease fluids to the site, decreasing painful swelling
Suggest OTC or prescribed pain medication (if necessary)
Suggest OTC or prescribed antihistamine, such as Bendadryl (if needed)
Keeping wound clean and dry
Apply ice for 20 minutes once every hour (if needed)
Warning signs if site gets worse and who to contact
Provide patient education on Epi-Pen (if needed)
REVIEWED BY: Carol Decker, RN, MSN, Clinical Staff Educator
WRITTEN BY: Ronnie Peterson, R.N., M.S., Manager of Clinical Support
Mayo Foundation for Medical Education and Research (November 23, 2010). Bee Stings – Treatment and Drugs.
Retrieved October 24, 2011 from http://www.mayoclinic.com/health/bee-stings/DS01067/DSECTION=treatments-and-
Smith, M. W. (April 27, 2010). WebMD, LLC. Treatment of Bee and Wasp Stings. Retrieved October 24, 2011
Medical Director Date