Insect bites and stings: managing allergic reactions.

This article concerns itself with three common reactions (local, toxic and anaphylactic) resulting from insect or arthropod bites and stings. A local reaction consists of sharp, localized pain followed by a reddening at the site, which usually resolves itself in 24 hours. A toxic reaction may include gastrointestinal symptoms, fever, headache, dizziness or convulsions, often following an episode of multiple stings. An anaphylactic reaction may be mild (hives, itching) or severe (systemic reactions including airway and cardiovascular symptoms). Even though most bites and stings are not serious, nurse practitioners should be aware of potential death resulting from insect sting allergy. They should teach hypersensitive patients, or patients with a history of a systemic reaction to any agent, about prophylactic measures. Tables showing the characteristics of insects that cause cutaneous lesions in humans, and measures necessary to decrease the risk of being stung, can be used as learning tools to prevent insect sting allergy. Because of the rapid onset of anaphylaxis, life-saving measures include awareness in persons who are hypersensitive, emergency preparedness and preventing bites and stings from occurring.