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Paediatric bites, stings and allergic reactions
What is paediatric bites, stings & allergy?
Paediatric bites and stings include insect stings, tick bites, animal and human bites, and contact reactions from plants or foods, while allergic reactions range from mild local swelling to life-threatening anaphylaxis with airway and breathing compromise. First aiders must distinguish minor local reactions from systemic features such as breathing difficulty, widespread rash or collapse that demand urgent escalation.
Handled well, most bites and stings can be managed with simple wound care, cold packs and observation, but a small minority progress to serious infection or systemic allergy. Effective first aid means recognising spreading redness, fever, breathing problems or facial and tongue swelling early, so that urgent medical treatment and, for known allergies, prompt use of adrenaline and 999 activation are not delayed.
Children frequently present with insect stings, animal bites and allergic reactions; most are minor, but a small proportion progress rapidly to anaphylaxis and need prompt adrenaline and calling 999.
Who needs this skill?
Health & Social Care
In health and social care, staff should follow local protocols for managing anaphylaxis, including immediate adrenaline for children with known allergies and rapid transfer to emergency care; they must also recognise infection risks from bites, particularly animal and human bites to the hands, face and joints, which often need antibiotics and tetanus review.Licensed venues & nightlife
Licensed venues and events that serve food or host families must take allergy declarations seriously; clear labelling, cross-contamination controls and trained staff who know how to respond to anaphylaxis with 999 calls and auto-injector support reduce clinical and legal risk.Schools
Schools and early years providers are on the frontline of paediatric allergy management; they should maintain up-to-date care plans, accessible auto-injectors, staff training in recognising anaphylaxis and Drs ABCD responses, and clear procedures for outdoor activities where stings and ticks are more likely.Workplaces
In workplaces and leisure settings, common issues include wasp stings, tick bites from outdoor activities, dog bites in parks and food-related allergic reactions at cafés and parties; staff should know basic wound care, when to seek urgent care and how to respond if a child collapses after a sting or allergen exposure.How to manage paediatric bites, stings & allergy
- 1Assess the reaction and historyCheck what caused the bite or sting if known, where it is on the body, and what symptoms the child has now; ask about known allergies, asthma, previous anaphylaxis or prescribed auto-injectors. Look for local redness and swelling, versus widespread hives, breathing difficulty, facial or tongue swelling, dizziness or collapse.Distinguishing a simple local reaction from early anaphylaxis is critical; systemic features and any involvement of airway, breathing or circulation should trigger urgent escalation and 999 activation.
- 2Provide local care for minor bites and stingsFor minor reactions without systemic symptoms, remove the sting if visible (scraping rather than squeezing), wash the area with soap and water, apply a cold compress and consider age-appropriate pain relief if authorised. Observe the child for any progression of symptoms and advise parents about signs that should prompt urgent review.Good local care reduces discomfort and infection risk, but safety-netting about what to watch for is essential in case symptoms worsen after the child leaves your care.
- 3Recognise and treat anaphylaxisIf the child develops breathing difficulty, wheeze, stridor, facial or tongue swelling, widespread hives, vomiting, collapse or a feeling of imminent doom after a sting, bite or allergen exposure, treat as anaphylaxis: call 999 immediately, use an adrenaline auto-injector if prescribed and available, and lay the child flat with legs raised (or in a position of ease if breathing is severely compromised).Early adrenaline, correct positioning and rapid ambulance activation significantly improve outcomes in paediatric anaphylaxis; staff should not delay while seeking permission if a known allergy and clear symptoms are present.
- 4Manage bites and infection riskFor animal and human bites, especially to the hands, face or near joints, rinse the wound thoroughly with running water, cover with a clean dressing and seek urgent medical advice due to high infection and cosmetic risk; tetanus and hepatitis status may need review.Bites carry a higher infection and safeguarding burden than simple insect stings; documentation, risk assessment and early clinical input are key, particularly if the circumstances are unclear or concerning.
- 5Consider ticks, rashes and safeguardingIf a tick is present, arrange careful removal with appropriate tools and follow local guidance on Lyme disease risk and monitoring for rashes or flu-like symptoms. Be alert to rashes that spread, fevers or unwellness after bites or stings, and consider safeguarding concerns where injuries are inconsistent with the history or recur repeatedly.Ticks and unusual bite patterns raise infection and possible safeguarding issues; organisations should have clear pathways for medical follow-up and escalation to safeguarding leads where necessary.
This guide is a learning reference only. It does not replace attended, assessed first aid training.
Qualifying courses
Qualsafe Level 3 Award in Paediatric First Aid (RQF)
2 days
3 years
Common questions
Practical answers for employers, venue managers, and healthcare teams about paediatric bites, stings & allergy training.
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