Insect Bites and Stings

1. Remove the stinger as quickly as possible. Use a clean fingernail or tweezers to grasp and pull out the stinger.
2. Wash the area with soap and warm water.
3. Apply a small amount of antibiotic, cream or gel to the wound if no known allergies or sensitivities.
4. Apply a cold pack to site. Wrap pack in a thin, dry towel.
5. Watch for changes in condition, including breathing and responsiveness and signs of shock, and give care as appropriate.
6. If signs and symptoms of severe allergic reaction/anaphylaxis, give care as appropriate and assist with or administer (if trained) medication (epinephrine).

What if I’m alone with the person who is experiencing anaphylaxis? Should I care first or call 9-1-1 first?

If you are alone, assist with administering medication and then call 9-1-1 or the designated emergency number. While you wait for help to arrive, make sure the person is sitting in a comfortable position. Have the person lie down if they are showing signs of shock.

If I want to prevent insect bites, what insect repellent should I use when going in a grassy or wooded area that may be infested with insects?

• Use an insect repellent containing diethyltoluamide (DEET).
• For a child, use an insect repellent containing up to 30% DEET.
• Do NOT use products with DEET on infants younger than 2 months.
• Apply it only once a day or according to the manufacturer’s instruction.
• Do not use a product that combines DEET-containing insect repellent with sunscreen.

1. Trained
   1. Have them sit in a comfortable position or lie down if showing signs of shock.
   2. Verify the medication with them.
   3. Remove the cap and safety device on the auto-injector.
   4. Locate the outside middle of one thigh to use as the injection site.
   5. Hold their leg firmly.
   6. Administer the medication at a 90-degree angle.
      1. Hold it in place for 3 seconds after a click is heard.
   7. Massage the injection area for 10 seconds.
   8. Note the time of administration and any changes in condition.
   9. If they have signs and symptoms 5 to 10 minutes after the first dose and EMS has not arrived, administer a second dose.
   10. Give the auto-injector to EMS on arrival.

1. Untrained
   1. Have them sit in a comfortable position or lie down if showing signs of shock.
   2. Give them the epinephrine auto-injector.
   3. Hold their leg firmly to limit movement.
   4. Encourage use of the auto-injector as prescribed.
      1. Make sure they hold the auto-injector firmly in place for 3 seconds after a click is heard.
   5. Massage or have them massage the injection area for 10 seconds.
   6. Note time of administration and any changes in condition.
   7. If they have signs and symptoms 5 to 10 minutes after the first dose and EMS has not arrived, help them administer a second dose.
   8. Give the auto-injector to EMS on arrival.

1. Assist with or administer (if trained) medication (epinephrine).
2. Continue checking them as appropriate to determine if additional care is needed.
3. Keep them from getting cold or overheated.
4. Give care for shock, if necessary.
5. Position the person as appropriate.
6. Reassure them you will help them, and that EMS has been called (if appropriate).
7. Watch for changes in condition, including breathing and responsiveness, and give care as appropriate and trained.