A few days ago, Master Zhang from Xianyang inadvertently violated the territory of the wasp on the tree while doing farm work. He was besieged by a swarm of bees, and was stinged more than 60 places on his body, and his injuries were life-threatening. Later, after transfer, Master Zhang was sent to Xianyang First People’s Hospital for rescue. After blood purification and other measures, Master Zhang was finally out of danger. Recently, Yuan Yaying, deputy director of the Department of Critical Care Medicine of the First People’s Hospital of Xianyang, analyzed the case.
Bee sting, multiple organ failure
Yuan Yaying said that at midnight that day, Master Zhang was pushed into the intensive care unit. The doctor on duty carefully checked the patient’s body and found that there were as many as 60 red and swollen skin on the patient’s scalp, chest and arms, and some ulcers. The condition is not optimistic. The medical staff immediately started rescue, inhaled oxygen for the patient, opened the venous channel, took blood tests to complete the relevant examinations, and gave ECG monitoring.
“The blood test results were not ideal, suggesting that the patient’s liver, kidney, heart, and lung function damage, multiple organ failure and rhabdomyolysis. The hospital formulated a treatment plan, using hormones, protecting the liver, nourishing the myocardium, rehydration, and correcting electrolyte acid. On the basis of symptomatic treatment such as alkali disorder, combined with CRRT and hemoperfusion therapy, blood purification + hemoperfusion started at 4 am on the same day, the process went smoothly, and the patient’s symptoms gradually eased. However, on the second day, the re-examination of myocardial enzymes and liver enzymes continued to rise. The patient’s condition is not optimistic. The patient’s multiple organ damage is serious, so plasma exchange treatment is urgently performed, and the replaced plasma is soy sauce color.” Yuan Yaying said that after more than ten days of treatment in the intensive care department, the patient experienced blood purification (blood After a series of treatments such as perfusion + hemofiltration), anti-shock, and high-dose hormone shock, he was out of danger, renal function improved, urine output gradually recovered, creatinine and myocardial enzymes decreased, and multiple organ functions improved, and he was transferred to the general ward. Continue related treatment, the current condition is stable.
Bee stings can be fatal
Yuan Yaying introduced that every summer and autumn (August-October) are the seasons of high incidence of bee stings, among which wasp stings are the most serious, which can be life-threatening if not treated in time or if they are not treated in time. 24 hours after the sting is the early stage, the sooner the better, especially within 6 hours, also known as “golden 6h”.
It is common in Xianyang to be stinged by bees and wasps (horses). The bees have venomous glands in their tails and a tail stinger attached to them. When stinging, the tail pierces the skin and injects venom into the body. Stung by a few bees, generally no systemic symptoms. If it is stung by most bees, it can cause large-scale swelling, and occasionally tissue necrosis. In severe cases, systemic symptoms such as nausea, weakness, and fever may occur, and even anaphylactic shock or acute renal failure may occur. Bumblebee stings can cause shock, coma, convulsions, cardiac and respiratory paralysis, and death.
The venom of bees is acidic and contains histamine, phospholipase A, hyaluronidase and hemotoxin. Wasp venom is alkaline and contains histamine, serotonin, acetylcholine and cholinesterase, among others. The wasp has venomous glands and tail needles on its tail. After stinging, it retracts the tail spine and can continue to sting.
If you are stung by a bee, you should take the following emergency measures:
1. For severe stings of the limbs, the proximal end of the stabbed limb should be bandaged. The total time should not exceed 2h, relax for 1min every 15 minutes, or use a cold towel to wet compress.
2. Carefully check the wound, if the tail thorn is in the wound, you can use a sterile needle to pick out the stinger.
3. Do not squeeze the wound to avoid the spread of venom.
4. Do not apply mercury bromide solution, iodine, etc. to the wound, which will aggravate the swelling of the affected area.
5. Determine the type of bee sting. The venom of bees is acidic. Soapy water or 5% sodium bicarbonate injection, 3% light ammonia water and other weak alkaline water can be used to wash the wound to neutralize the toxin. The wasp’s venom is alkaline, and a weakly acidic liquid such as 1% acetic acid or household vinegar can be used to wash the wound.
6. For local redness and swelling, calamine lotion can be used to dissipate inflammation. Topical creams such as antihistamines and pain relievers can also be used. Redness and swelling accompanied by severe edema can be wet compress with 3% boric acid solution.
7. Bee stings should be observed carefully. If the situation is serious, seek medical attention immediately. Don’t be careless. If you are stung by a highly toxic wasp and other insects, do not hesitate to go to the nearest hospital immediately!
China Business Daily reporter Yang Ning editor Niu Peiyao