Stinging Insect Allergy

Availability

North South North West Statewide

Pre-referral work-up

History

All referrals should comply to referral standards and also include:

  • History of reactions to insect stings, specifically worst reaction experienced
  • If patient has experienced reactions to different insects, detail type of insect and reaction that occurred to that insect
  • Date of last sting and severity of reaction
  • Detail type of insect if known i.e. Jack Jumper, Honey Bee etc. If unknown please indicate 'unknown insect'
  • Time frame from sting to onset of each symptom
  • Treatment administered - Was adrenaline given?
  • If attended hospital, Medical Centre, GP practice, which one & when?
  • Do they have an EpiPen & ASCIA Action Plan/Training?
  • Past medical history
  • Current medications
  • Correct patient contact details (especially phone numbers)

Example: 64 year old female stung by a Jack Jumper on the 4 January. Within 10 minutes of sting extensive rash on torso, throat tightness, difficulties breathing and chest tightness. Took antihistamine and called '000'. Ambulance arrived 35 minutes after sting and IMI adrenaline was administered. Transported to Royal Hobart Hospital, observed for 4 hours. No hypotension or loss of consciousness. Currently has two Epipens. PMHX: etc. Meds: etc. especially cardiovascular, respiratory.

Interim/GP management

To refer a patient with this condition, please see the Jack Jumper clinic page for the full referral process and templates.

The Australasian Society of Clinical Immunology and Allergy (ASCIA), Action Plan can be used as a guide to the severity of an anaphylactic reaction.

http://www.allergy.org.au/images/stories/anaphylaxis/2014/ASCIA_Action_Plan_Anaphylaxis_Epipen_Personal_2014.pdf

Note: Venom immunotherapy is not indicated for the treatment of local reactions to insect stings.

For more information please see the Tasmanian Health Pathways website.

Emergency

Anaphylaxis

Urgent / category 1

Patient at occupational risk of further stings.

Red flags are clinical indicators of possible serious underlying conditions requiring further medical intervention. They may or may not indicate an emergency.

Emergency:

Proceed to Emergency Department (ED). Please contact ED Medical Officer in Charge:
LGH ED – Phone: (03) 6777 6405  Fax: (03) 6348 7382
MCH ED – Phone: (03) 6478 5120  Fax: (03) 6441 5923
NWRH ED – Phone: (03) 6493 6340  Fax: (03) 6464 1926
RHH ED - Phone: (03) 6166 6100  Fax: (03) 6173 0489

Urgent:

Urgent referrals should be accompanied by a phone call to the Consultant/Registrar to organise urgent review and the referral must be faxed.

We will endeavour to see these patients within four weeks, or sooner if clinically indicated.

Semi-urgent:

We will endeavour to see these patients within 12 weeks

Routine:

Next available appointment