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The Situation: Your party is hours or days from the trailhead, when one of the party stumbles on a yellowjacket nest and is stung multiple times by the tiny fighter aircraft.

The person had been stung several times before, and suffered only swelling around the stings, but never had a systemic reaction (no anaphylaxis).

What should this person do? Should he get out as fast as possible because of the number of stings and because a relatively mild reaction on a previous occasion does not guarantee a relatively mild reaction on the next occasion? Or should he stay quiet, applying cold compresses (ideally with snow, if accessible) to the stings?

(This happened to me last weekend while doing yard work, but I was a mere 2.5 mile drive from a walk-in clinic and went immediately there, where I got a Benadryl shot and a prednisone-related shot. Within ten minutes, the swellings disappeared.)

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"Get out as fast as possible" doesn't make sense considering you are "hours or days" from a trailhead. If the allergic reaction is going to kill you, like swelling up your throat to the point you can't breath, it's going to happen within about 20 minutes.

If you have someone in your party with such alergies, it is imperative you bring medications to deal with it. Certainly you need some antihistamine. That's a good idea to have in your kit anyway. Someone with known severe alergies to things in the woods should also bring epi-pens and show others where they are and how to use them. The epi mitigates the immediate symptoms in the short term. That allows you to give them the antihistamine that hopefully kicks in before the epi wears off.

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    +1 for reminding folks that epipens are a delaying tactic, not a treatment/cure. – Matthew Wetmore Jul 29 '17 at 5:57

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