Ants, Bees and Wasps

 First aid for hymenopteran sting is removal of the sting if necessary. In patients where anaphylaxis is likely, immediate medical attention is necessary.

The ants, bees and wasps all belong to the insect order Hymenoptera. Stings to the non-allergic patient have a similar presentation across species, although there is variation in severity. The venom of this group appears to be particularly likely to be allergenic, and anaphylactic reactions to these animals are second only to snakes in terms of cause of death related to venomus animals in Australia.

Signs and Symptoms

Single or few stings in a normosenstive patient will typically cause localised pain, swelling and erythema at the site. When stings are numerous, this can be accompanied by:

  • Headache
  • Nausea and Vomiting
  • Oedema
  • Thirst
  • Pain
  • Haematuria and/or myoglobinuria
Death haas occurred in cases where several hundred stings are received, but a patient presenting as clinically ill after as few as 10 stings should be hospitalised.

Hypersensitive patients can develop rapid and catastrophic anaphylaxis.


Treatment for normosensitive patients involves removal of the sting if one is present, oral or topical analgesia as indicated, and the application of ice packs or cold water immersion.

Where systemic reaction to numerous stings is a problem, the patient should be transferred to a critical care facility. Renal function should be monitored and palliative treatment implemented. Tetanus immunisation status should be updated if necessary.

If even a single sting has occurred to a hypersensitive patient, immediate transfer to critical care is essential, without waiting to see whether anaphylaxis develops.