(Chelsea Update would like to thank Barry Nemon, director of the Chelsea Hospital Emergency Room, for the information in this column.)
Well, it’s officially summer and as Director of the ER, it’s time to talk about some of the more common seasonal complaints.
Some of the most common problems are bee and wasp stings. Often, patients have a great deal of local swelling and come to the Emergency Room for advice. They may have tried oral Benadryl or topical Benadryl or even hydrocortisone cream, but the swelling just does not seem to respond.
They want to know if this swelling is an allergic reaction that needs some special treatment.
Bee sting reactions can be generalized or localized.
A generalized reaction can be a rash located all over the body or low blood pressure or trouble breathing. When someone is having a generalized reaction, they should be seen right away. And, when patients know that they have this tendency, they should carry an epi-pen and Benadryl with them so there is no delay in starting treatment.
But what about those local reactions, the ones with swelling around the site where the person was stung? Well, the best way to stop local swelling from a bite or sting is to immediately put ice on the area — before it swells.
If that’s not possible, ice afterward will also help. What does not help is oral Benadryl or topical Benadryl or over-the-counter steroid creams.
So what is a person to do who has all of this swelling on a finger or arm, all localized to the site of the bite? Well, as long as it is not red (which would suggest infection) the treatment is “time, ice, elevation”. Nothing else seems to work very well.
Oral Benadryl really does not help, as this is not a generalized allergic reaction.
These patients are often sent home from the ER with reassurance. And that sometimes is worth a lot.
If you have questions you’d like Dr. Nemon to answer, please email me at [email protected].
