A 10-month-old male is stung by a bee. The skin around the site is reddened with localized swelling; lungs are clear; vitals are stable. What is the most appropriate action?

• A. Administer a pediatric epinephrine autoinjector
• B. Administer oxygen
• C. Monitor him and transport
• D. Assist his ventilation

Answer: (C)

The key idea is recognizing when a bee sting is a localized reaction rather than anaphylaxis in a young child. In infants, airway, breathing, and circulation guide what you do. This child has only a reddened, swollen area at the sting site, lungs clear, and stable vital signs—no signs of airway swelling, wheezing, hypotension, or altered mental status. That means there’s no current anaphylaxis and no immediate need for life-saving meds or interventions.

So the best action is to monitor him and transport to a facility for observation. While you monitor, you can provide comfort and basic local care: gently clean the area, consider removing the stinger if it’s still present (scraping with a flat edge rather than squeezing), apply a cool compress to reduce swelling, and reassess vitals regularly. Because symptoms can progress to a systemic allergic reaction, continue to watch for warning signs such as swelling of the lips or tongue, widespread hives, facial swelling, coughing or wheezing, vomiting, or any change in mental status. If any of those occur, immediately escalate to epinephrine and emergency transport.

Oxygen and ventilation support aren’t indicated here since there’s no respiratory compromise, and administering a pediatric epinephrine autoinjector isn’t appropriate without signs of anaphylaxis. The infant should be observed and transported for further evaluation to ensure no progression.