Patient discussions

Patients with an insect bite or sting should be advised that skin redness and itching are common and may last for up to 10 days, but it is unlikely that the skin will become infected.[67] Patients should avoid scratching if possible, as this may reduce inflammation and the risk of infection. It is important to highlight the need to seek medical help if symptoms worsen rapidly or significantly at any time, or if the patient becomes systemically unwell.[67]

Patients who suffer severe reactions to insect bites or stings must be educated that they are at high risk of similar (i.e., severe) reactions in the future. Patients who have had respiratory symptoms or anaphylactic reactions should be discharged with a prescription for two adrenaline (epinephrine) auto-injectors and be instructed in their proper use.[2][3]​​​​​​[5]​​[28]​​[53]​​​​ 

Because auto-injectors need to be available quickly, patients should carry both with them at all times.​​​[53]​​ This allows for extra doses to be available in case of rebound or biphasic reactions.[47]​​[36][77]​ Patients need to be advised that their use is only intended as an adjunct (not a substitute) for prompt medical care. Advise caution about exposing auto-injectors to extremes of temperature and against storing in the glove compartment of a car.

Patients and carers are advised to periodically review their auto-injector instructions and practice administration with a trainer device. Users of EpiPen® adrenaline (epinephrine) auto-injectors should inspect their device prior to needing it to ensure the blue safety release is not raised and that the device can be easily removed from the carrier tube.[78]​ Many patients will receive generic or alternative brand auto-injectors, which requires specific education, training, and practice for each device.

Patients should also be educated about the possibility of rebound reactions as their treatment medications wear off. They should be told to return if they experience any breathing difficulties (e.g., wheezing, shortness of breath) or swelling/tingling in their mouth or throat. Patients with minor dermatological reactions should also be instructed about the relatively small possibility (estimated at less than 1%) of more severe reactions in the future.[19]​ They can be taught to self-treat with antihistamines and anti-inflammatory medications if symptoms are limited to dermatological reactions, but they should return if any respiratory or oral symptoms are experienced.

Patients should be instructed to continue taking medications as prescribed by their doctor, which may include corticosteroids or antihistamines. They should also be instructed to inform their regular doctor about the event and any regular medication prescribed. Patient information on insect bites and stings is available. NHS choices: insect bites and stings Opens in new window

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