Emergency Flowchart
| Signs and symptoms1 | Emergency medical treatment | Antivenom | ||
| Patient history:
Is the patient known to have a Hymenoptera allergy? |
No antivenom available | |||
| Nausea, vomiting, abdominal pain, diarrhoea, urticaria, angio-oedema, bronchospasm, arterial hypotension (systemic allergic reaction) | Treatment of general allergic reactions | |||
| Extensive local swelling (strong allergic reaction) | Treatment of local allergic reactions | |||
| Extensive local swelling possibly involving the trunk → hypovolaemia → hypovolaemic shock (increased regional capillary permeability) | Treatment of the hypovolaemia/hypovolaemic shock | |||
| Multiple stings
Jaundice, urine colour, acute renal failure (haemolysis) |
Treatment of the haemolysis, if necessary
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| Multiple stings
Muscle pain (spontaneous, with active/passive movement), urine colour, ECG changes, paralysis (rhabdomyolysis) |
Treatment of the hyperkalaemia; hypercalcaemia;
prevention and treatment of the acute renal failure; treatment of the respiratory insufficiency/respiratory failure; endotracheal intubation and artificial respiration |
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| 1 | See also the Clinical flowchart as a guide to the dynamics of envenoming. |