Anaphylaxis Insights

I teach beekeeping at a local college. Recently, one of my students, an experienced beekeeper, was stung three times while working one of those hives. She’s been stung before; she did not mention feeling any cause for alarm. As we were finishing up anyway, she said she was returning to the classroom (as were others, although trailing behind her.)
What then happened to her will forever change the way I keep bees and teach classes.
Through divine intervention, a student had (unusually) stayed behind in the classroom. They began chatting. With apparently no warning to either of them, she lost consciousness. Anaphylactic shock.

Based upon witnessing firsthand how life-threatening that was, here are some of the changes we will consider and likely make—both in the teaching environment and when I work bees with just a few friends. In no particular order:

* Discuss the possibility of anaphylactic shock every time I work bees with a “new” person, what it can look like, how fast it comes on, what to do. ER physician Tyler Andre recommended this site: Dr. Andre had given an awesome anaphylaxis / beekeeping first aid presentation at Kalamazoo’s bee school February of 2017.
* Make it clear to everyone to call 911 at the first sign of trouble. It happens SO fast.
* Keep my cell phone in my protective suit pocket – not in my purse, not (somewhere) in my car. On my person, in an outside pocket so I can grab it.
* Read and review epi-pen operation at least seasonally. (Some of us with over-50 eyes had trouble reading the directions, and our reading glasses were of course, not readily available.)
* Know who carries epi-pens if with a group. Make sure the pens are with us, not locked in a car across the parking lot.
* Move a person in anaphylactic shock to a position where blood can get to their brain – horizontal if possible, or head between their knees. Dr. Andre said horizontal is best as it allows the person to be turned on their side if they start vomiting.
* Know who in the group has medical training. (We were blessed to have a nurse in the group monitoring vitals who rapidly brought the EMTs up to speed upon their arrival.)
* Monitor the person in shock’s pulse. Start chest compressions if they don’t have a pulse while awaiting the EMTs.
* Make it standard procedure that when anyone gets a sting, they let someone else know. That includes the folks who are routinely stung and think nothing of it. They will probably be just fine, but any sting could be the one that causes a severe reaction.
* If someone who is stung steps away from the group because they are feeling “off” / thirsty / warm / whatever – someone stays with them until it passes. Sit them down where you can easily lay them down if need be.
* If you think you might have a reaction, get away from the apiary if possible. First responders typically do not have the protective wear to treat someone near angry bees, and it may take time until the right equipment arrives.

* Carry Benadryl into the yard, and let everyone know I have it and where it is.
* Discuss beforehand that you cannot force Benadryl into an unconscious person. It can cause more problems. (We did not pursue this at the time, but it was discussed afterward.)
* Know the address where you are in case you need to call 911. (I often mentor and find myself in remote apiaries without really knowing where it is other than something like “four miles past the big red barn turn right on the dirt road, follow it for half a mile and you’ll see us on the hill by the grove of pines.”)
* Know where other emergency equipment is (first aid kid, AED if available.)
* Have emergency contact information for anyone I’m working with.
* Don’t work bees alone if possible. If not possible, make sure someone knows where you are and what you are doing … and no shortcuts on the protective wear.
* If you are involved with a bee club or group, it may be important for participants to sign waivers acknowledging the (very real) risk of working bees for protection of the club, landowner, institution, participants and instructors.

Our impacted student went home from the ER later that night, shaken but okay. I feel the same way; it happened so fast, seemingly out of nowhere. Almost like bees in a hive, our class came together in these moments of crisis to administer medications, flag down the ambulance, and take care of the impacted student and each other. We are grateful it worked out as it did; we feel responsible to work to make sure that the next time it happens it will also have a happy ending.