Anaphylactic shock

[bushman1872]

* HP morphine is a pain reliver nothing else, adrenaline is a potentially life saving drug.
* I re-highlight the point about developing anaphylaxis over many years, I have just bought some kit of someone that had this happen.
* Generally speaking most of our hives are probably not next to hospital so lets hope you can get an ambulance to you and some paramedics who can give you the stuff you need.
* No don't buy any medication off the internet or ebay that is dumb and dangerous
* The 'best treatment ' is prompt recognition, 999, adrenaline and then hospital.
* This is my last post on the matter as i'm frankly bored with it all now i just hope and pray that none of you ever find your selves in the position of being able to help somone and not doing so. They teach in basic life support that to do something is better than to do nothing, the consequences of your actions can be no worse than death. Finally Milker mel no paramedic or doctor automatically knows whats wrong with a person unless they have some sort of medi alert they will simply treat what they see.

Time is of the esscence

 

[Waxing]

Medical Question

Does anyone know whether someone who has a nut allergy is stung by a bee that has been foraging on a nut tree for pollen or resin would be affected by the 'nut' connection please?

 

[drstitson]

theoretically possible though likely rare - would need to be a severe allergy - could relate some interesting tales about various ways in which nut allergies can manifest themselves through very indirect intimate contact.

 

[Hombre]

Audience sits patiently for the doctor to commence a general informational discussion . . . Imagination probably filling in a lot of blanks just from the suggestion,

As they say in radio circles - K

 

[hedgerow pete]

whilst i undersatnd the whole nut allergy thing i realy do strugle with that and bees. i know the two follow a very similar path but i would rather the beekeeping forum stayed with beekeeping problems, i am sure there is a nut allergy forum some where

 

[TBRNoTB]

If were going into DIY medicine can I prefer to try out a tracheotomy? I carry round a biro and scalpel just in case. Also I've heard removing a kidney can help in these cases. As it's an honest belief that I'm acting in their best interests can I try that out too?

What a berk.

 

[Karol]

Just picked up on this thread albeit nearly three months after the last post. I have to be careful what I say because of my professional status. Epipens are definitely prescription only medicines and administering adrenaline to someone who not only isn't suffering AS but may also have another concurrent condition, could be fatal. Part of the GPs job is to check that the patient is safe to receive adrenaline on other medical grounds.

What is also interesting as well as AS is the emerging medical data on Kounis syndrome. This appears to be more prevalent with wasp stings but can also happen with bees stings. In Kounis syndrome (which manifests itself as a heart attack up to two weeks after the sting), the use of adrenaline could also actually be fatal.

One off the shelf medicine which I would recommend that bee keepers keep at home or with them is Piriton (Chlorpheniramine 4mg) which is an antihistamine (I promise I have no stake in Piriton). This can be taken reasonably safely in response to a sting, with drowsiness the most likely symptom. The rule here is don't drive or operate heavy machinery and if you're showing signs of AS call an ambulance and don't drive cos you might also harm someone else on route.

One other thing that I find interesting with St Johns advice for first aiders about AS is the advice to keep AS patients calm and warm. I recall a case of a child being stung by a wasp on a motor yacht in the English channel. The child developed AS and the parents (one of whom at least was a medic) got the child to run on the spot until the yacht could get into Southampton. They did this to naturally raise adrenaline levels to combat the AS. The child survived.

Kind regards,

 

[Dewin Dwl]

If you are issued with an Epipen, I promise you it doesn't hurt when you use it but your thigh will be a little sore in the morning (like a deadleg).

You will the spend some time feeling bloody awful as you lie on your side waiting for the ambulance. Concentrate on steady breathing and get you feet raised a few inches to keep your blood in your head/core. Best of luck.

Thick clothing helps. Vinyl gloves over soft leather gloves seem to avoid hand stings without losing too much feel. Also keep you bee shed orderly and clean, to avoid attracting bees. I also regularly "smoke out" my shed with my beesuit hung up. It seems to make me less noticed by the bees. (Smoke out = leave smoker sitting quietly in shed, never seems to go out......unlike when left quietly in apiary when you really want smoke!! Treacherous things)

 

[drstitson]

Karol - the generic anti-histamines are exactly the same dose and a fraction of the cost of P*****n.

 

[Karol]

Karol - the generic anti-histamines are exactly the same dose and a fraction of the cost of P*****n.

Granted. I suggested Piriton instead of Chlorpheniramine 4mg because it's easier to remember. Also, it's important to understand that there are only two antihistamines out of the dozen or so which are on the market which are licensed for use in anaphylaxis, i.e. Chlorpheniramine and Promethazine. I think there is a danger that if people ask for a generic 'antihistamine' they might get the wrong one which is why I think it is important to be specific in this instance.

Hope this helps.

 

[bellabee]

Hello,

I have suffered full AS this year.

I started beekeeping not knowing I was allergic, it was only when I was stung the second or third time it set in, I had a whole season under my belt before that.

It was a hospital visit for sure, bed, pills, drip in arm and bloods, followed by carrying an epipen.

I have now started on the desensitization course at my local hospital, and should be fine to go back to the bees next spring.

I would hope if I was in shock someone could use the epipen in leg. I have started to keep a diary of my programme on my blog here:

Admin edit: Please do not link to own websites.
On the bee sting immunology tab.

By asking about I have had contact with 5 or 6 other beekeepers in my local area who are also allergic, so they are a few of us about.

 

[bellabee]

Dewin Dwl, are you allergic?

 

[Karol]

Hello,

I have suffered full AS this year.

I started beekeeping not knowing I was allergic, it was only when I was stung the second or third time it set in, I had a whole season under my belt before that.

It was a hospital visit for sure, bed, pills, drip in arm and bloods, followed by carrying an epipen.

I have now started on the desensitization course at my local hospital, and should be fine to go back to the bees next spring.

I would hope if I was in shock someone could use the epipen in leg. I have started to keep a diary of my programme on my blog here:



On the bee sting immunology tab.

By asking about I have had contact with 5 or 6 other beekeepers in my local area who are also allergic, so they are a few of us about.

The desensitization course won't offer 100% protection so it would be adviseable to continue taking all necessary precautions. Depending on what medical papers you read, the success rates don't exceed 95% at best.

A sage piece of advice if you continue bee keeping is to ensure that someone always knows where you are and that you get a personal alarm linked to a remote monitoring site. That way, if you do get into difficulties out in some field somewhere and you are by yourself, medical aid can still get to you reasonably quickly.

Regards,

 

[drstitson]

95% at best is excellent for a medical treatment of any kind.

AFAIK desensitisation for bee sting allergy is the most successful programme available - so better to get a scare with a bee than a peanut!

 

[bellabee]

Karol, I hope to go back to my bees next spring when I am up to two stings, I have heard from other beekeepers who have gone back that they are up and running again after the initial eleven week period, which is good. Although I do fully intend to be well prepared with extra clothing all over, epipen, tablets, mobile and bee buddy

The programme I am on offer venom from real bees, rather than the national which is man made, I will be jabbed with both. The success rate is higher with their own venom.

I would also never go to my bees alone.

I will keep the forum updated of the progress for anyone that is interested

Dr.S, 95% and/or higher at Addenbrookes damm good if you ask me. I also did not know it was better than peanut... Any reason?

 

[Dewin Dwl]

Bellabee, yes I am allergic.

Last year no problem.

Second sting of the season this year (Good Friday) I came over all strange: shakey, getting hot, tingles in hands. Scrambled shut the hive I had open (see thread about killing a colony - it was them) ran to the house, took a couple of chlorophanmine pills, rang 999, got on the floor and waited. Spent the following 24hrs in A&E under observation as I had sweated out enough fluid to leave a body print on the carpet. Hellish low blood pressure and slow slow pulse. The Doctors all reckoned my fitness from fell-running helped with resisting the situation. Received my first epipen in the morning when being kicked-out.

I had a sting from a different hive a fortnight later. Two pills (yes a double dose) of chlorophenamine and sat waiting for the symptoms before banging in an epipen. Felt unwell, worrying and waiting but nothing more. So epipen was unused.

Since then I've had two more A-shocks , both linked to the evil-hive's bees. Hence I know what the epipen feels like.

Oddly my last reaction only lasted some five minutes but it did leave me feeling wrecked for a couple of hours. Am I desensitising? Its a nice thought but I doubt it. I'm probably becoming more expert at discharging the epipen into my leg!!

For now I wear plenty of clothing layers, ensuring adequate thickness around places like wrists. My rig is not clumsy, just carefully thought out. The hard bit has been finding a glove system that lets me work with some sensitivity but also adequate protection. My gloves are supple leather with nitrile gloves (XXXL) over the top. The bees don't seem to be able to sting when on the nitrile. I guess they can't grip it to set the sting so it can draw itself into my hand. I haven't the nerve to try double nitrile alone......I just feel the need for some distance between my skin and Mrs Bee.

(A Bee's sting is a fantastic example of how something thin and flexible can be made to act as if rigid through use of barbs/ratchet. It does not work like a hypodermic where it has to be rigid enough to push through skin. Have a look at an old sting, it is so thin and much too flexible to *** into your skin. Get your beekeepers association microscopy-nut to show you the mechanics. As an Engineer I am just so in awe of the design. Another example of the awesomeness of bees, individually and as a colony!)

I'm weighing up the info on the other thread about a desensitising programme. It may be my way forward.....or a bigger epipen!!

 

[Dewin Dwl]

Oh, top tip.
Most antihistamine tablets are tiny fiddly things you drop when trying to get out of the blister pack whilst in a slight panic. I keep two in an old camera film canister ready to swallow (pop the lid first!!). Very easy as first line of defence, even when wearing gloves or with shakey hands.

 

[bellabee]

Dewin Dwl, I thought you had gone on the programme? Jeessshhh you are a brave man going near your bees, although you have the good ol' Epipen I guess!!

Can you post the link to 'How to kill a colony' sounds like an interesting read. Is this why you wiped them out = evil bees? We hope to replace our queen next spring for a calmer one, in the hope trips to the hive are more pleasant, there is nothing like dealing with angry bees and A.shock at the same time. Fact!

I had my first appointment last Tuesday and there are a few beekeepers on the programme, all which I am in touch with. I would recommend the programme to you perhaps put the wheels in motion and go see your GP for a referral to Immunology where they will do some skin tests for bees. Unfortunately the time from GP to that is about two and a half months, so I highly recommend you get going if you want to get on it soon, for next spring perhaps?

After the initial eleven weeks you could be back to the bees and have no reaction, no more Epipen, no more pills (they told me double dose too) no more giant Epipen

Good advice about keeping in a camera film case... will go do that now. Also great advice on the gloves too, I will sort that as well. I am going to add my blog link to my profile so people can find it, I have a section on their about how I am getting on with the immunology programme. I love beekeeping and hope to continue soon.

Good to know I could use the Epipen if I needed to you sound like a pro? Did you have to go to A&A after use?

Great information on the bees sting I never considered it really, they really are fantastic little things.... and they make honey... nom nom nom!!!

Stay in touch x

 

[Karol]

I've read these posts with great interest. Allergic reactions are incredibly complex and what Derwin says is intriguing. It might just be that the 8mg dose of chlorpheniramine was taken early enough to subdue the reaction from the different hive.

That said, it is also quite feasible that there are slight differences in the toxins between the different hives leading to different responses. This could be important in respect of any desensitisation programme and the success thereof. I know more about wasp venom than I do about bee venom. I do know that the venom contains different allergenic toxins which behave in different ways. Some of them are designed to cause destabilization of the mast cell causing a histamine cascade (amongst other things) which can lead to AS. Other allergenic toxins are designed to cause delayed onset allergic reactions (type II through IV). So it's not only AS that you have to be careful about.

Emerging medical data on Kounis syndrome is raising big concerns. There's a paper that was published in late 2008 which if true, may suggest that there could be any where between 1000 and 1400 people dying each year from wasp and bee stings. Typically these patients die of a sting induced heart attack that might take up to 2 weeks to develop after the sting. By then they've forgotten that they've been stung and the medics don't associate the heart attack with the sting.

So, if anyone starts suffering chest pains a few days after a sting, it's worth getting checked out pronto and taking a couple chlorpheniramine 4mg tabs probably won't go amiss. Using an epipen for Kounis isn't safe so its worth talking to your doctor about the difference between AS and Kounis and what to do in each case.

Best wishes,

Karol

 

[jimbeekeeper]

between 1000 and 1400 people dying each year from wasp and bee stings.

Yes, and about 10,000 per year (world wide) killed by lighting.

And these people where not flying kites trying to get struck, unlike us beekeeprs who are flying the kite.

Get it in perspective people!