Scraping or pinching for removal of bee stings
Date First Published:
March 12, 2010
Last Updated:
April 29, 2010
Report by:
Stijn Van de Velde, Staff Member Expertise Center (Belgian Red Cross-Flanders)
Search checked by:
Emmy De Buck, Belgian Red Cross-Flanders
Three-Part Question:
In [patients with bee stings] is [removing the sting by scraping better than removing by pinching] at [reducing localized reactions in the patient]?
Clinical Scenario:
A 42 year old woman attends the emergency department after having been stung by a bee on her shoulder. You examine her and find marked local reactions. The woman tells you that she used tweezers to remove the sting. You wonder if the method of removal might have affected the reaction to the bite.
Search Details:
Medline 1966-1 March 2010 using the Pubmed interface:
("Insect Bites and Stings/therapy"[Mesh]) AND ("Bees"[Mesh] OR "Bee Venoms"[Mesh]) LIMITS to English.
Embase 1947-1 March 2010 via the Embase.com interface:
‘Insect bite’/exp AND (‘bee’/exp OR ‘bee venom’/exp) LIMITS to English.
The Cochrane Library:
MeSH descriptor Insect Bites and Stings explode all trees AND Mesh (MeSH descriptor Bees explode all trees OR Mesh descriptor Bee Venoms explode all trees)
("Insect Bites and Stings/therapy"[Mesh]) AND ("Bees"[Mesh] OR "Bee Venoms"[Mesh]) LIMITS to English.
Embase 1947-1 March 2010 via the Embase.com interface:
‘Insect bite’/exp AND (‘bee’/exp OR ‘bee venom’/exp) LIMITS to English.
The Cochrane Library:
MeSH descriptor Insect Bites and Stings explode all trees AND Mesh (MeSH descriptor Bees explode all trees OR Mesh descriptor Bee Venoms explode all trees)
Outcome:
259 papers were found of which only 1 was relevant. This paper is summarised in the table.
Relevant Paper(s):
| Study Title | Patient Group | Study type (level of evidence) | Outcomes | Key results | Study Weaknesses |
|---|---|---|---|---|---|
| Removing bee stings. Visscher PK, Vetter RS, Camazine S 1996 USA | 1)Two volunteers with 20 self-administered bee stings each, for which the sting was removed after 2s by scraping with the edge of a credit card versus by pinching the sting between thumb and finger and pulling it out. 2)One volunteer with 50 self-administred bee stings in which the sting was removed by scraping after 0,5s vs. 1s vs. 2s vs. 4s vs. 8s |
Within subjects design | Size of the weal (mm²) after 10 minutes | 1)The method of removal did not significantly affect the weal size (scraping: mean 80 [SE 5.9] mm²; pinching:mean 74 [SE 5.1] mm²; p=0.42). 2)Weal size increased significantly with increasing time from stinging to removal (p=0.018). | Study with only two subjects, serious risk of carry over effects |
Author Commentary:
When scraping, the sting broke on multiple occasions. This did not occur with pinching.
Bottom Line:
This study suggests that removing the sting as soon as possible after the bite is more important than the method of removal.
Level of Evidence:
Level 3: Small numbers of small studies or great heterogeneity or very different population
References:
- Visscher PK, Vetter RS, Camazine S. Removing bee stings.