A child is brought to the clinic immediately after being stung by a wasp while playing in the yard. The physical examination reveals localized redness and edema at the site, along with abdominal tenderness, watery eyes, and generalized hives. What is the initial treatment?

A child is brought to the clinic immediately after being stung by a wasp while playing in the yard. The physical examination reveals localized redness and edema at the site, along with abdominal tenderness, watery eyes, and generalized hives. What is the initial treatment?

• A. Administer intramuscular epinephrine.
• B. Apply a topical glucocorticoid cream.
• C. Give oral diphenhydramine.
• D. Order a bronchodilator treatment.

Answer: (A)

When a wasp sting triggers a systemic allergic reaction, the immediate concern is anaphylaxis. The combination of local sting symptoms with widespread hives, abdominal pain, and eye symptoms signals that the reaction is not limited to the sting site and can progress rapidly to airway compromise or shock. The first-line, life-saving treatment is intramuscular epinephrine. Epinephrine counteracts the dangerous changes in the body by constricting blood vessels to reduce swelling and improve blood pressure, and by relaxing airway smooth muscle to relieve bronchospasm and airway edema. In children, the typical initial dose is about 0.01 mg/kg of a 1:1000 solution, given intramuscularly, with a usual maximum per-dose limit; if symptoms persist or recur, repeat and seek emergency care promptly. After epinephrine, additional measures like antihistamines or bronchodilators may be used as adjuncts, but they do not replace the need for prompt epinephrine in suspected anaphylaxis.

When a wasp sting triggers a systemic allergic reaction, the immediate concern is anaphylaxis. The combination of local sting symptoms with widespread hives, abdominal pain, and eye symptoms signals that the reaction is not limited to the sting site and can progress rapidly to airway compromise or shock. The first-line, life-saving treatment is intramuscular epinephrine. Epinephrine counteracts the dangerous changes in the body by constricting blood vessels to reduce swelling and improve blood pressure, and by relaxing airway smooth muscle to relieve bronchospasm and airway edema. In children, the typical initial dose is about 0.01 mg/kg of a 1:1000 solution, given intramuscularly, with a usual maximum per-dose limit; if symptoms persist or recur, repeat and seek emergency care promptly. After epinephrine, additional measures like antihistamines or bronchodilators may be used as adjuncts, but they do not replace the need for prompt epinephrine in suspected anaphylaxis.