Safety, Stings & Allergic Reactions

In this lesson: how to tell a normal sting reaction from a dangerous one, what to do about each, and how to work your hives so you rarely get stung in the first place.

By the end of this lesson you can: sort a sting into normal, large local, or systemic; name the signs that mean call 911; remove a stinger the right way; and set up a hive-side safety kit and a lone-worker plan.

You are going to get stung. Most stings are nothing: a bright pain, a small welt, forgotten by dinner. But a small number of people react in a way that can kill them, and the difference between a hobby and a hospital visit is knowing which reaction you're looking at and what to do. This is the most important lesson in the free module, so read it twice.

A note before we start: we're beekeepers, not doctors. Nothing here is medical advice. It summarizes guidance from the American College of Allergy, Asthma & Immunology (ACAAI) and the U.S. National Library of Medicine, and it's meant to send you to your doctor with the right questions. If you have ever had a whole-body reaction to a bee or wasp sting, see an allergist before you keep bees.

The Three Types of Sting Reaction

Learn to sort stings fast, because your response differs for each.

	Normal local	Large local	Systemic (anaphylaxis)
What you see	Pain, redness, and swelling stay at the sting site	Swelling spreads beyond the sting, generally more than 3 inches; a hand sting can swell the forearm	Symptoms away from the sting: hives or itching elsewhere, swollen lips, tongue, or throat, trouble breathing, dizziness or fainting, vomiting or cramping
Timing	Fades in a day or so	Usually peaks 2 to 3 days after the sting and can last a week or more	Can begin within minutes
Danger	Not an allergy	Painful but not life-threatening	Medical emergency
What to do	Wash, ice	Ice, elevate the limb, antihistamine; see a doctor if severe or if it's near your face or airway	Epinephrine if prescribed, call 911, go to the emergency room

Normal local reaction

This is what nearly everyone gets and should expect every time. Remove the stinger, wash the area, and apply ice.

Large local reaction

More common than beginners expect. Swelling extends well beyond the sting, can be alarming to look at, and is miserable, but it stays around the sting area and is not life-threatening, according to ACAAI. Ice, elevation, and antihistamines help. Tell your doctor about severe or repeated large reactions.

Systemic reaction and anaphylaxis

A systemic reaction means the body is reacting all over, not just where the sting landed. Anaphylaxis can begin within minutes and may be life-threatening.

Signs of Anaphylaxis

If any of these appear after a sting, especially away from the sting site, treat it as anaphylaxis:

• Hives, itching, or flushing on parts of the body the bee never touched
• Swelling of the lips, tongue, throat, or face
• Tightness in the throat or chest, a hoarse voice, trouble swallowing
• Wheezing, coughing, or any difficulty breathing
• Dizziness, fainting, or a sharp drop in blood pressure
• Rapid pulse, pale or clammy skin
• Nausea, vomiting, abdominal cramping, or diarrhea

The tell is distance and system: symptoms show up far from the sting and involve breathing, circulation, or the gut, not just skin around the welt.

When to Call 911

Call 911 immediately, and do not wait to see if it passes, if you or anyone with you has:

• Any trouble breathing, throat tightness, or swelling of the face, lips, or tongue
• Faintness, collapse, or confusion after a sting
• Hives or swelling spreading across the body
• A known history of serious sting reactions and a fresh sting

If in doubt, call. Symptoms can return after they seem to ease, so anyone treated for a severe reaction should go to the emergency room even if they feel better.

While you wait for help, MedlinePlus advises laying the person flat and raising their feet about 12 inches to help prevent shock, unless they're vomiting or it causes discomfort, and following the dispatcher's instructions. Don't give anything by mouth to someone having trouble breathing.

Epinephrine and Antihistamines (Not Medical Advice)

Talk to your doctor. Here's the general shape of what's recommended, so that conversation makes sense.

• Epinephrine auto-injector: the first-line treatment for a severe allergic reaction. It's prescription-only. If you or a family member is at risk, your doctor may prescribe one. Keep it with you at the hives, not in a drawer in the house. Learn how to use it from your prescriber or pharmacist and follow the printed instructions on your device. Check the expiration date. Always call 911 after using it. ACAAI notes that recent guidelines recommend keeping two doses available because one may not be enough.
• Antihistamines: over-the-counter, helpful for itching and local swelling. They do not treat anaphylaxis. Never rely on an antihistamine when someone can't breathe.
• Get tested if you've ever reacted systemically. An allergist can confirm a venom allergy and discuss venom immunotherapy (allergy shots). ACAAI says the shots can protect up to 98% of people if they're stung again, typically over a three-to-five-year course. That's a doctor's decision, not ours.

Sting First Aid

1. Remove the stinger quickly. If it's still in the skin, scrape it off with a straight edge such as a credit card or your hive tool. ACAAI says not to pinch the stinger or use tweezers, since that can release more venom.
2. Move away and puff a little smoke on the spot. A sting releases alarm pheromone that attracts more stings; smoke masks it. If bees are getting worked up, calmly close up and step away.
3. Wash and ice it. Ice and elevation reduce swelling. Use ice in short intervals rather than leaving it on for long stretches.
4. Itch and pain. Antihistamines, ice, or calamine can help itching; follow package directions for over-the-counter pain relief. Don't scratch it open.
5. Stay aware. Anaphylaxis can begin within minutes, so don't keep working alone right after a sting that worries you, and tell someone nearby.

How to Reduce Stings

The best sting is the one you never get. Most come from rushing or bad timing.

• Light your smoker before you need it and keep it lit the whole inspection. A few cool puffs at the entrance and under the cover calm a colony more than anything else you'll do.
• Move slowly and deliberately. Bees read fast, jerky motion as a threat. If a bee bumps your veil, ignore it; swatting escalates it.
• Pick the right time and weather. Work on a warm, calm, sunny day in the late morning to mid-afternoon, when many foragers are out. Avoid dusk, cold, wind, and the hours before a storm. During the summer dearth colonies get defensive and robbing runs high; work fast and close up promptly.
• Wear your gear properly. Zip fully, tuck pant legs into boots, use thumb loops, and check for gaps before you open a box. Light colors only.
• Stay out of the flight path. Work from the side or back of the hive.

Protecting Family, Neighbors, and Pets

• Point entrances away from walkways, patios, pools, and the neighbor's yard, and put a fence or hedge near the entrance so bees fly up and over head height.
• Give bees a close, reliable water source so they don't work a neighbor's pool or a dog bowl.
• Ask your household and close neighbors whether anyone has a known bee-sting allergy before you set up. If someone does, that changes placement and whether an epinephrine auto-injector lives in the house.
• Keep dogs and curious kids away from the hive fronts. Pets can have serious reactions too; a dog stung in the mouth or many times needs a vet quickly.

Working Alone: Tell Someone Your Plan

If you'll be at the hives alone, tell someone where you are and when you expect to be done. Carry a charged phone in a pocket you can reach inside your suit. A rare bad reaction, a fall, or heat exhaustion in a summer suit can leave you unable to help yourself. A two-minute text ("at the hives, back by three") is the cheapest safety gear you own.

If you're at higher risk or new and nervous, do your first several inspections with an experienced keeper nearby. Your local club will happily pair you up.

Your Hive-Side Safety Kit

Build this before the bees arrive and keep it with you, not in the house:

• Antihistamine tablets
• A cold pack or access to ice
• An epinephrine auto-injector if your doctor has prescribed one, for you or a family member
• A charged phone
• Water (heat is a bigger threat than bees in a Central Valley summer suit)
• A household check done: you know whether anyone in your home or next door has a sting allergy

The overwhelming majority of beekeepers go their whole lives with nothing worse than a sore thumb. But the keepers who get hurt are almost always the ones who didn't know the difference between a welt and an emergency, or who were alone with no way to call for help. Now you know both.

Check Your Understanding: Module 1

Five questions covering the whole module. Try each before you open the answer.

1. A friend offers you a used hive with drawn comb for $40. What do you check before saying yes, and what's your answer?

Answer

Ask where the comb came from and its disease history. Never use used drawn comb from an unknown source, because American foulbrood spores can persist on equipment for decades. Used boxes that are scorched clean inside can be fine; drawn comb of unknown history is a hard no.

2. You're picking a first hive and you have a bad back. Which configuration do you consider, and what must you decide before you buy?

Answer

An 8-frame Langstroth, possibly all-medium equipment so every box is lighter and every frame interchangeable. Decide width (8 vs. 10) and depth (deep vs. medium) before buying, because those parts don't mix.

3. Your backyard has full afternoon sun, no water nearby, and the entrance would face your neighbor's patio. What would you change, and what must you do with the state?

Answer

Find or create afternoon shade (especially inland), set out a shallow water source with landing spots a week or two before the bees arrive, and turn the entrance toward open space or a fence or hedge so bees fly up and over. Register the apiary with CDFA through BeeWhere (due January 1 each year, or within 30 days of acquiring bees), and check city rules and any HOA covenants.

4. At the end of year one your colony is alive but you harvested no honey. Did you succeed?

Answer

Yes. Year one is about building comb and population, surviving mites and winter, and learning. A queenright colony that overwintered, plus records and mite-sampling skill, is the goal.

5. A coworker is stung on the hand, and 10 minutes later has hives on her chest and says her throat feels tight. What do you do, and what should you not rely on?

Answer

Call 911 immediately; hives away from the sting plus throat tightness signals anaphylaxis. Use an epinephrine auto-injector if one is prescribed to her and follow the device instructions, and help her lie flat with her feet raised unless she's vomiting or it's uncomfortable. Don't rely on an antihistamine, which doesn't treat anaphylaxis. She should go to the emergency room even if she improves.

Sources

• Insect Sting Allergies, American College of Allergy, Asthma & Immunology (reaction types, stinger removal, epinephrine, venom immunotherapy)
• Anaphylaxis, MedlinePlus, U.S. National Library of Medicine (symptoms, 911, positioning, what not to do)