MEASURES

 ·       Remove embedded stings from the skin with a blade or by brushing not by forceps as you might squeeze in some more of the venom.

·       Clean and disinfect the site of sting with soap and water , followed by spirit and then apply icepacks to slow the spread of venom. A tourniquet may slow the spread of venom.

·       Tetanus toxoid 1 ampoule IM stat into the deltoids( if immunised) + Tetanus immunoglobulin (if unimmunised)

·       Elevation of the affected site.

·       Analgesics and oral antihistaminics topical Calamine lotion.

·       Large local reactions may need oral therapy with Prednisolone.

·       Patients with numerous stings should be monitored for coagulopathy and evidence of renal failure.

SPECIFIC MEASURES

·       Anaphylactic reactions can be managed with subcutaneous 0.3-0.5ml of 1: 1000 dilution of Adrenaline, repeated every 20-30 mins if necessary.

·       Parenteral antihistaminics, bronchodilators, steroids, oxygen, intubation may be required asin any other form of anaphylaxis.