Refer a patient with a severe insect sting reaction to secondary care if they have had a suspected systemic hypersensitivity or toxic reaction to an insect sting or bite NICE CKS.
Arrange immediate admission to Accident and Emergency for anyone who is suspected of having a systemic hypersensitivity or toxic reaction, or has had a previous systemic allergic reaction to the same type of sting NICE CKS.
Refer if the patient has been stung on the mouth, throat, or tongue and is at risk of airway obstruction, or around the eyes with risk of compromised vision NICE CKS.
Refer if cellulitis is associated with systemic effects or worsening despite treatment in primary care NICE CKS.
Arrange referral for people stung by an unusual insect or from tropical/sub-tropical areas, or if they have systemic effects such as fever or persistent lesions, especially if the sting occurred abroad NICE CKS.
In cases of suspected anaphylaxis, after emergency treatment, refer to a specialist allergy service for further investigation and management NICE CG134.