Most of us have had the experience of being stung by an insect—most commonly in this area by a bee, wasp, or yellowjacket. The majority of us will notice a mild swelling at the sting site and a temporary discomfort that gradually fades away. However, for about 3% of the population—about two million people in the U.S.—a sting or bite from an insect can lead to an anaphylactic reaction that can be life threatening without emergency treatment. It is estimated that there are 40 to 100 deaths per year from this cause.  
An allergic reaction is triggered by the injection or ingestion of a protein that causes a cascade of chemical reactions by the immune system. Histamine and other chemicals are released in sensitized people that lead to dilation of blood vessels, tissue swelling and restriction of smooth muscle in our lungs. Symptoms of a severe allergic reaction include:
• Trouble breathing
• Hives that appear as a red, itchy, spreading rash 
• Swelling of the face, throat, or mouth tissue
• Wheezing or trouble swallowing
• Restlessness and anxiety
• Rapid pulse
• Dizziness or a sharp drop in blood pressure
If you are unfortunate enough to experience multiple stings, you can still have a serious reaction even if you are not sensitive.  Symptoms include:
• Nausea, vomiting or diarrhea 
• Headache 
• Vertigo 
• Feeling faint or fainting 
• Convulsions 
• Fever 
Receiving multiple stings is considered a medical emergency in children, older adults and people who have heart or breathing problems, and requires immediate medical attention.
How to avoid being stung
1. Know the insects that cause you problems.  Obviously honey bees like to be near flowers and hives. Avoid them if you can. 
2. Wear shoes and socks when outdoors.
3. Wear long-sleeved shirts, long pants, socks and shoes in rural or wooded areas.
4. Perfumes and brightly colored clothing attract insects.
5. If you have severe allergies, try to have someone with you if outside hiking, camping or in areas of high insect concentrations. 
6. Spray garbage cans regularly with insecticide, and keep the cans covered.
7. Avoid or remove insect-attracting plants and vines growing in and around the home.
8. If you’re severely allergic, always wear identification bands that say you have an allergy. Keep an epinephrine kit on hand in case of an emergency.

Emergency treatment of bee stings
IF YOU ARE ALLERGIC OR ARE EXPERIENCING ANAPHYLACTIC SYMPTOMS:
The most important actions you can take if a sting occurs to a severely sensitive person are first to call 911 and then to assist or administer epinephrine. The epinephrine blocks this immediate reaction so that there is not a drop in blood pressure, throat swelling or airway constriction.
A premeasured dose of epinephrine can be administered by a syringe or by the use of a self-administered device, such as an Epipen, Auvi-Q, or Adrenaclick (brand names). The use and instruction on administration of a self-administered device is easy.  A person with severe allergic reactions to stings and other serious allergies needs to have these kits in the home, car and on their person.  
Currently these devices are in the news because of a recent spike in the cost per unit for one brand; it is to be hoped that the bad publicity will help resolve this in the near future.  
The person should be transported to an emergency room by EMS, if possible, because there are other medications that need to be administered intravenously, along with monitoring of breathing and cardiac status, in order to prevent a full anaphylactic reaction. 
IF YOU ARE NOT ALLERGIC:
• If you are stung on the hand, remove any rings from your finger in case there is serious swelling.
• A honey bee usually leaves a sac of venom and a stinger in your skin. Other stinging or biting insects do not. Remove the stinger within 30 seconds to avoid receiving more venom. Gently scrape the sac and stinger out with a fingernail or a stiff-edged object like a credit card. Don’t squeeze the sac or pull on the stinger, or more venom will get into you.
• Wash the stung area with soap and water, then apply an antiseptic.
• Apply a soothing ointment, like a hydrocortisone cream or calamine lotion, and then cover the area.
• Apply an ice pack or cold compress to the area, if there is swelling or hives.
• Use an over-the-counter oral antihistamine to ease itching, swelling and hives. Some physicians also recommend taking a medication such as ibuprofen for discomfort. If you are pregnant or the stung person is under two years of age, check with your doctor’s office before taking any medication.