Patient discussions

Patients who suffer severe reactions to insect bites or stings must be educated that they are at high risk for similar (i.e., severe) reactions in the future. Patients who have had respiratory symptoms or anaphylactic reactions should be discharged with a prescription for two epinephrine (adrenaline) auto-injectors and be instructed in their proper use.[2][3]​​​​​​[5]​​[28]​​[53]​​​​ 

Because auto-injectors need to be available quickly, patients should carry both with them at all times.​​​[53]​​ This allows for extra doses to be available in case of rebound or biphasic reactions.[36][47][76]​​​ Patients need to be advised that their use is only intended as an adjunct (not a substitute) for prompt medical care. Advise caution about exposing auto-injectors to extremes of temperature and against storing in the glove compartment of a car.

Patients and caregivers are advised to periodically review their auto-injector instructions and practice administration with a trainer device. Users of EpiPen® epinephrine auto-injectors should inspect their device prior to needing it to ensure the blue safety release is not raised and that the device can be easily removed from the carrier tube.[77]​ Many patients will receive generic or alternative brand auto-injectors, which requires specific education, training, and practice for each device.

Patients should also be educated about the possibility of rebound reactions as their treatment medications wear off. They should be told to return if they experience any breathing difficulties (e.g., wheezing, shortness of breath) or swelling/tingling in their mouth or throat. Patients with minor dermatologic reactions should also be instructed about the relatively small possibility (estimated at less than 1%) of more severe reactions in the future.[19]​ They can be taught to self-treat with antihistamines and anti-inflammatory medications if symptoms are limited to dermatologic reactions, but they should return if any respiratory or oral symptoms are experienced.

Patients should be instructed to continue taking medications as prescribed by their doctors, which may include corticosteroids or antihistamines. They should also be instructed to inform their regular doctor about the event and any regular medication prescribed.

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