Anaphylaxis Insights

I teach beekeeping at a local college. One of my students, an experienced beekeeper, was stung three times while working hives. She’s been stung before; she did not mention feeling anything different. She finished up hive inspection and told me she was returning to the classroom because of the heat … as others also intended to do.

What then happened to her has forever changed the way I keep bees and teach. Through divine intervention, another student had (unusually) stayed behind in the classroom. They began chatting. With apparently no warning, she lost consciousness and collapsed on him. Anaphylactic shock.

Based upon witnessing firsthand how life-threatening that was, here are some of the changes I’ve made—both in the teaching environment and when I work bees with just a few friends. It happens so fast.

General points:

  • No shortcuts on the protective wear. However, I understand (and salute) those of you who don’t wear gloves, although my student took all her stings to her bare hands, which in retrospect—gloves may have postponed her learning of her severe allergy
  • I discuss the possibility of anaphylaxis every time I work bees with a “new” person, what it can look like, how fast it comes on, what to do. I suggest the Mayo Clinic information on anaphylaxis for us non-medical folks, and if you can handle the medical terminology, beekeeper and ER MD Tyler Andre recommends
  • My cell phone is always in an outside pocket of protective wear – not in my purse, not (somewhere) in my vehicle, not in a pocket inside my suit
  • At least seasonally, I read and review epinephrine autoinjector operation. (Some of us with over-50 eyes can’t read the directions without reading glasses, which are not always handy)
  • Identify who carries epinephrine autoinjector if with a group. Make sure the pens are in the apiary, not locked in a vehicle across the field
  • Know who in the group has medical training. (We were blessed to have a nurse in the group monitoring vitals; she then rapidly brought the EMTs up to speed upon their arrival)
  • Did I mention no shortcuts on the protective wear? And always make sure the zippers are closed. Bees help you find those little gaps if you don’t check for them. 🙂
  • 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. Our student who went down had been keeping bees for years
  • Know where other emergency equipment is (first aid kid, AED if available)
  • Have emergency contact information for anyone you’re working with
  • Don’t work bees alone if possible. If not possible, make sure someone knows where you are and what you are doing. My EMT friend who works bees alone keeps his cell phone in his chest pocket and on an open call, letting them know he’s OK every few moments, and if he gets stung
  • Carry Benadryl into the yard, and let everyone where it is. However, you cannot force Benadryl into an unconscious person. It can cause more problems
  • No shortcuts on the protective wear. Oh did I mention that already?
  • Be smart about when you’re working in the hive: not too early, not too late, not when there’s bad weather. (Along with not when there are children, animals or innocent bystanders nearby)
  • 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

If you’re stung:

  • Step AWAY from the hives and scrape out the stinger as quickly as possible
  • Smoke the stung area heavily to override the pheromone the stinging bee(s) left behind
  • Tell someone so they can keep an eye on you
  • If you are feeling “off” / thirsty / warm / jittery / confused / whatever – get out of the yard and be monitored closely. Recline at about a 30-45 degree angle so gravity may assist if nausea develops, and so you may be lay down if need be. Plus, if you’re already lying on the floor and you go into shock, you avoid the possible further injuries from falling down. GETTING AWAY FROM THE BEES is critical; First Responders typically do not have the protective wear to treat someone near bees and they won’t approach you until it is safe

If someone develops anaphylaxis:

  • Move the person to a position where blood can get to their brain – fairly horizontal if possible, or head between their knees. Dr. Andre prefers horizontal; it allows the person to be turned on their side if they start vomiting.
  • Monitor their pulse. Start chest compressions if they don’t have a pulse while awaiting First Responders.

Our impacted student went home from the ER later that night, shaken but alive (!!) She’s okay, thank goodness and amen.

I am also okay, but afterward was very shaken. 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, direct the EMTs, and take care of the impacted student and each other. We are grateful it worked out; we feel responsible to work to make sure that the next time it happens it will also have a happy ending.