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Project No.4-419-0381 August 29,2019 Page No. 19 Anaphylaxis, if treated in time, usually can be reversed by the effects of epinephrine (adrenaline) injected into the body. Individuals who are aware that they are allergic to stings should carry epinephrine in either a normal syringe (sting kit) or in an auto-injector (Epi-Pen) whenever they think they may encounter stinging insects.Epinephrine is obtainable only by prescription from a physician.Antihistamines potentially have value in combating non-life-threatening reactions, but should be used according to a physician's instructions. Another method of combating anaphylaxis is desensitization. In this approach, the patient is subjected to injections of the venom to which he or she is allergic in increasing doses over a period of time. Like hay fever shots,the tactic is to build up a protective concentration of antibodies in the blood that will intercept and tie up the venom components before they can reach the antibodies on the mast cells. Desensitization with pure venom works about 95 percent of the time. Multiple Stings Occasionally, a person becomes involved in a situation where he or she is stung many times before being able to flee from the nesting site. Depending on the number of stings,the person may just hurt a lot, feel a little sick,or feel very sick.Humans can be killed if stung enough times in a single incident.With honeybees the toxic dose (LD50) of the venom is estimated to be 8.6 stings per pound of body weight. Obviously, children are at greater risk than adults.In fact,an otherwise healthy adult would have to be stung over 1,000 times to be in risk of death. Most deaths caused by multiple stings have occurred in men in their 70s or 80s who were known to have poor cardiopulmonary functioning. Renal Insufficiency A second,potentially life-threatening result of multiple stings occurs days after the incident.Proteins in the venom act as enzymes: one dissolves the cement that holds body cells together, while another perforates the walls of cells. This damage liberates tiny tissue debris that would normally be eliminated through the kidneys. If too much debris accumulates too quickly, the kidneys become clogged and the patient is in danger of dying from kidney failure. It is important for persons who have received many stings at one time to discuss this secondary effect with their doctors. Wasp stings are as potent in this respect as bee stings. Patients should be monitored for a week or two following an incident involving multiple stings to be certain that no secondary health problems arise. Avoiding Stings Bees and wasps can be attracted to,or may react to,odors in the environment. It is best not to use perfume, cologne,or scented soaps if you are going into an area of bee or wasp activity.Unless someone accidentally collides quite hard with or swats at a bee or wasp,it is not likely to sting.Avoid going barefoot in vegetation, especially clover and blooming ground covers. Also avoid wearing brightly colored or patterned clothing. If you remain calm when a bee or wasp lands on your skin to inspect a smell or to get water if you are sweating heavily,the insect will eventually leave of its own accord.If you don't want to wait for it to leave, gently and slowly brush it away with a piece of paper. When swimming in pools, watch out for bees or wasps trapped on the surface of the water. If you find bees or wasps in the water, it is best to remove them to avoid being stung. Stinging incidents often occur when nesting areas of social insects are disturbed. Be observant of the area around you. If you see insects flying to and from a particular place, avoid it. If you are going to be in an area where disturbing a nest is likely, wear long pants and a long-sleeved shirt. It might be a good idea to carry a military surplus, collapsible mosquito/gnat veil with you. Stinging insects often fly around the top of their targets.Because stings in the face can be disorienting,put on the veil,or pull a portion of your shirt over your head,and run away. SALEM engineering group. inc.