Stings

Bee stings are a common risk when working in or near an apiary. While most stings are mild, some may lead to life-threatening allergic reactions. This guide outlines appropriate responses, first aid, prevention tips, and legal considerations for administering epinephrine.

If signs of a systemic allergic reaction appear call 911 immediately and consider using an epinephrine auto-injector (e.g., EpiPen) if available.

Responding to Bee Stings: What to Do in the Moment

Scenario	What to Do
Single Sting	Take a deep breath, avoid quick movements Remove stinger (see Treatment and First Aid below) if safe to do so Use smoke on the sting site to mask alarm pheromones Assess colony behavior before continuing work
Multiple Stings	Close up hive if safe to do so Do not swat or flail arms If you need to escape, run as far away as quickly as possible if unsafe level of stings, there is no benefit to zigzagging when you run. Bees will pursue an enemy 1/4 mile or more. Cover face and neck if without PPE, as long as it doesn’t obstruct your escape Seek physical separation (e.g. get inside a vehicle and drive away) Do not hide underwater - bees may wait

Fun Fact: Honey bees fly up to 20 mph; most humans sprint at ~7 mph.

Treatment and First Aid

1. Remove the Stinger Quickly: If stung by a worker honey bee, the stinger may remain embedded and continue pumping venom.

If stung by a honey bee, the stinger may remain in the skin and continue injecting venom
Remove with any scraping or pulling object: fingernail, hive tool, credit card, or tweezers
Research shows pinching does not significantly increase venom—speed matters more than technique

2. Cleanse the Area: Wash with soap and water, rubbing alcohol, or hydrogen peroxide

3. Address Local Reactions

Apply a cold compress
Elevate the affected area if possible
Consider an oral antihistamine (e.g., diphenhydramine/Benadryl)

4. Monitor for Systemic Symptoms: Refer to the Bee Venom Allergies section below for warning signs of anaphylaxis

Bee Venom Allergies

Allergic reactions to bee venom vary widely. While most people experience only mild, localized symptoms, some individuals can develop a life-threatening reaction called anaphylaxis. Sensitivity can change over time, even someone who has been stung many times before without issue can develop a severe allergy later in life. We divide the severity of the allergy into two categories:

Localized Reaction	Pain, redness, swelling, and itching at the sting site Typically resolves within hours or days Occurs in nearly everyone
Systemic Reaction (Anaphylaxis)	Difficulty breathing or wheezing Swelling of the lips, tongue, or throat Dizziness, confusion, or fainting Rapid heartbeat or low blood pressure Nausea, vomiting, or diarrhea Skin symptoms (hives, flushing, itching) beyond the sting site

Anaphylaxis is a whole-body allergic reaction caused by widespread immune system overactivation. It can occur within minutes, even in individuals with no prior allergic history. Always seek emergency medical attention, even if symptoms subside. Anaphylaxis can be bi-phasal, with a "second wave" occurring 1-72 hours after initial exposure.

If you’ve never been stung or have relatives with severe allergic reactions, consider asking your primary care provider about bee venom allergy testing. This can help identify risk before an emergency occurs.

Epinephrine Auto Injectors

Epinephrine is a life-saving drug for individuals experiencing anaphylaxis due to severe allergic response. The drug works by constricting blood vessels, relaxing airway muscles, reducing swelling, and Inhibits further chemical release from mast cells. We recommend having two epinephrine auto-injectors available during every apiary visit.

Legal Use in California

You can be sued for administering an epinephrine auto-injector to a non-immediate family member.
To be waived of legal liability, California requires Epinephrine Certification for lay-persons (non-medical professionals) to administer epinephrine to a non-immediate family member. We recommend beekeepers to get this certification.

How to Administer

Always read and follow instructions that come with an epinephrine autoinjector. Steps to administer:

Ask for permission: “Can I administer epinephrine to you? It’s a life-saving medication for severe allergic reactions.”
Remove from carrier tube
Remove the blue/gray safety cap
Place the orange tip firmly against the outer thigh (through clothing if needed)
Push until it clicks, then hold for 10 seconds
Call 911 if not already done
If symptoms return and no medical help has arrived, a second dose may be given after 5–15 minutes

Watch this video on how to inject and make sure to practice with the practice injector typically provided with every epinephrine auto-injector purchase.

Purchasing and Maintaining

Epinephrine auto-injectors are prescribed and cannot be purchased over the counter. Primary health providers usually prescribe one when asked and you can pick it up at the pharmacy.
"EpiPen" the brand drug, however generic versions are widely available and effective
A 2019 analysis found median out‑of‑pocket spending after insurance was about $63 per two‑pack of branded EpiPens. Generic versions averaged just $10 out‑of‑pocket. Almost two‑thirds of patients paid less than $20.

Immunotherapy

Venom immunotherapy (allergy shots) is a highly effective treatment that can significantly reduce sensitivity to bee stings over time. It is becoming more accessible and widely covered by insurance. Talk to your healthcare provider or allergist about whether it’s right for you.