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Availability of Insect Sting Kits to Non-Physicians

National Institutes of Health
Consensus Development Conference Statement
September 14, 1978

Conference artwork, a bee or yellow jacket on yellow orange background with the title above.

This statement is more than five years old and is provided solely for historical purposes. Due to the cumulative nature of medical research, new knowledge has inevitably accumulated in this subject area in the time since the statement was initially prepared. Thus some of the material is likely to be out of date, and at worst simply wrong. For reliable, current information on this and other health topics, we recommend consulting the National Institutes of Health's MedlinePlus http://www.nlm.nih.gov/medlineplus/.

This statement was originally published as: Availability of Insect Sting Kits to Non-Physicians. NIH Consens Statement 1978 Sep 14;1(7):30-31.

For making bibliographic reference to the statement in the electronic form displayed here, it is recommended that the following format be used: Availability of Insect Sting Kits to Non-Physicians. NIH Consens Statement Online 1978 Sep 14 [cited year month day];1(7):30-31


Introduction

The conference considered the epidemiology, morbidity, and mortality on anaphylactic reaction reactions to insect stings (Hymenoptera and Solenopsis, or fire ants), evaluated the availability and effectiveness of therapy by health-care professionals and others and determined whether undue delay in reaching definitive care contributed importantly to morbidity. The panel discussed whether changes in the current mode of management should be recommended, possibly including broader availability of "insect sting kits" containing injectable epinephrine, antihistaminic tablets and a tourniquet. A summary of the panel recommendations follows:

  1. The panel recognizes that everyone is a potential victim of life-threatening or fatal allergic reactions from stinging insects. Although the panel realizes that valid data regarding the incidence of these occurrences are not available at this time, the data presented to the panel suggest that such allergic reactions occur with greater frequency than is generally thought. Prior identification of those individuals who will so react is difficult.
  2. The panel believes that better education of the lay and professional populations will improve documentation of these events and tend to promote immediate and effective medical treatment, which can prevent the majority of fatalities.
    1. Reducing the size of the problem requires two approaches. The educational approach entails instructing both laymen and professionals on the dangers of insect stings and on the means to treat them. The service approach entails increasing the availability of treatment--to the maximum extent permitted by law--by encouraging and allowing all personnel who are properly trained to administer such emergency treatment at the site of the emergency.
    2. The belief that certain individuals are restricted from providing treatment may be based less on the applicable law than on misunderstanding of the state of law in this area. Given the objective of increasing the availability of emergency treatment, the panel encourages evaluation of the legal risks, placing them in the proper perspective.
    3. Teaching films and written materials for the lay public should be developed and distributed to help promote recognition of the problem of anaphylactic reactions to insect stings and to make known the available therapeutic regimens. These should be disseminated by interested organizations such as school and parent organizations, youth groups, farmers, industrial and labor organizations, and other groups whose members are at high risk. We urge that people allergic to insect stings use available methods to identify their sensitivity to others.
    4. Education of physicians should include information on emergency management of systemic reactions, emergency drugs, and the use of immunotherapy (hyposensitization). Physicians and other health-care personnel should instruct patients about the importance of avoiding insect stings and about the treatment of life-threatening reactions to such stings. Warnings should be given about the possibility of adverse drug interactions.
  3. The panel considered and rejected the option of making insect sting treatment kits, containing a predetermined dose of epinephrine for injection, available as an over-the-counter product. In the absence of individualized instruction for its administration, the panel believes there is considerable potential for inappropriate use of the kit by individuals with hypertension, certain cardiovascular diseases, or those who are taking certain medications. The panel believes these concerns would not be addressed adequately by labels or printed instructions that might be required for an over-the-counter item. The drug abuse potential for such kits was also of great concern.
  4. Research is needed to determine whether there may be other drugs and/or modes of administration that would he more effective and safer than current methods.

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