Transcript Diapositiva 1 - Suffolk Beekeepers

A tale of stings and reactions
Dr Jon Tuppen
Sproughton
"Eros stung by a bee, when he
inhaled the pleasant fragrance of a
rose, went crying to take refuge in
the arms of Venus," Dear mother, I
die, have mercy on me, a flying
snake bit me painfully cheek "
Anacreontic singing, 6th c. av. AD "
Alfred Dürer, 1514: Eros, Venus and the
bees
What is this?
Melittin – 26
amino acid peptide
Is this an allergic response?
Bee Venom: Composition, Health, Medicine: A
Review Stefan Bogdanov
http://www.bee-hexagon.net/files/file/fileE/Health/VenomBookReview.pdf
Sting components all designed to break
down normal permeability
The
recognition
systemseek and
destroy
....then things get a bit
complicated
Anaphylaxis – what is it?
• Acute onset of an illness (minutes to several hours) with
• involvement of the skin, mucosal tissue, or both (e.g.,
generalized hives, pruritus or flushing, swollen
lips/tongue/uvula)
• Respiratory compromise (e.g., dyspnoea, wheeze–
bronchospasm, stridor, reduced PEF [peak expiratory flow],
hypoxemia)
• Reduced BP (blood pressure) or associated symptoms of
end-organ dysfunction (e.g., hypotonia [collapse], syncope,
incontinence)
• Persistent gastrointestinal symptoms (e.g., crampy abdominal
pain, vomiting)
• Sense of Impending doom
Clinical features of systemic reactions
to bee or wasp stings
Generalised pruritus
Urticaria
Angioedema
Laryngeal oedema
Asthma
Gastrointestinal
Visual disturbances
Hypotension without LOC
Loss of consciousness
Ewan 1984
Bee (11)
Wasp (43)
6
6
5
5
4
6
3
5
3
24
24
26
11
20
15
7
16
15
}
} 72%
}
} 88%
}
UK cases of fatal anaphylaxis
Where are people most likely to
get stung?
n=278
How to recognise anaphylaxis
How to recognise anaphylaxis
How to recognise anaphylaxis
Anaphylaxis – what to do if it
happens.
• Shout for Help!! Don’t take chances –
phone 999 – remove sting
• If the person has medication – give it– Antistamines
– Steroids
• Use Adrenalin auto-injector sooner rather
than later i-m in outer thigh
– Repeat x 1 after 5mins if no improvement
• Get patient to hospital for observation
How to give i-m Adrenalin
Thank You