BEE ATTACK ADVICE: GRAB STINGER AND YANK, ASAP : EXPERTS REVERSE OLD WISDOM AFTER TESTING OWN WELTS.

Byline: Denise Grady N.Y. Times News Service

The time-honored advice for taking care of bee stings, quoted faithfully in medical texts and first-aid manuals everywhere, is wrong, according to a study published in the current issue of The Lancet, a British medical journal.

This challenge to tradition, expected to set the medical world abuzz, concerns the proper way to remove the stinger, or, as entomologists prefer to call it, the sting.

Bumblebees and wasps, including yellow jackets, rarely leave these barbed weapons embedded in their victims, and so were not involved in the new study. But honeybees nearly always leave the stinger with the sting, and the fact that the bees rip off their hind ends in the process and die is small consolation for the pain they inflict.

The standard recommendation has long been to scrape or tease the stinger out of the skin carefully with the edge of a knife blade, fingernail or, nowadays, a credit card, and never to pinch, pluck or grab it. That might seem logical enough; a venom sac is still attached to the back end of the stinger, and it does look as if squeezing the sac would squirt more venom into the wound, making it swell and hurt even more.

``It was thought to be like squeezing the bulb of an eyedropper or a turkey baster,'' said Richard Vetter, an entomologist at the University of California, Riverside, and one of the new study's authors. ``That makes sense until you test it.''

It was their own experience with bees as much as their training as scientists that led Vetter and two other entomologists, Dr. P. Kirk Visscher, also of Riverside, and Dr. Scott Camazine of Pennsylvania State University to question the established wisdom. Longtime beekeepers, they have each been stung thousands of times, and it seemed to them that speed mattered more than style in removing stingers.

``I knew from my experience as a beekeeper,'' Visscher said, ``that if you get the sting out quicker, you're better off.''

``Medical people in general, and I can say this because I'm one of them, don't really know very much about the practical aspects of treating bee stings,'' said Camazine, who was an emergency room physician before becoming an assistant professor of entomology.

The researchers' theory also was based on their knowledge of honeybee anatomy. What few people realize is that the honeybee leaves its victim not only the stinger and the venom sac, but also a chunk of its abdomen, a cluster of nerves, various muscles and, as the scientists politely describe it, the end of its digestive tract.

Even with the rest of the bee gone, enough nerve and muscle remain attached to the stinger to keep it twitching visibly, working its barbs deeper into the flesh and pumping more venom out of the sac by means of organs that resemble a valve and piston.

``It's the kind of thing insects are notorious for,'' Visscher said. He compared the disembodied pumping action to the ability of some male insects to continue mating even after females have bitten their heads off.

He and his colleagues reasoned that if a person could pluck out the stinger before all the venom was pumped out of the sac, a smaller, less painful welt might result.

They set out to test their hypothesis by experimenting on themselves. First, to determine whether the size of the welt depended on the amount of venom entering the skin, Camazine gave Visscher a series of injections containing measured amounts of bee venom. Sure enough, the diameter of the welts, as well as their soreness, increased along with the amount of venom used.

Next, the team wanted to find out whether the amount of time it took to remove a stinger would affect the size of the welt. Visscher, as head of the research team and first author of the paper, was once again chosen as the volunteer subject, Vetter said, noting that this phase of the study involved a considerable number of bee stings. ``That's the price of fame and fortune,'' he added.

Standing alongside a hive in the laboratory, Visscher would catch a worker bee, grasp her by the wings and press her against the inside of his forearm until she stung. He did this repeatedly over the course of several days, scraping out the stingers at various intervals, from half a second all the way up to eight seconds after being stung. Vetter was kept unaware of how long each stinger had been left, and he measured the welts after 10 minutes.

Fifty stings later, the researchers had shown that time was indeed of the essence; the longer the stinger stayed in, the bigger the welt. When it was left in place for eight seconds, the resulting welt was a third larger than it was when the stinger was removed after one second. Leaving it in longer, they assumed, must have let more venom enter the skin.

Finally, the scientists compared methods of stinger removal: the medically correct scraping technique vs. the heretofore forbidden grab-and-yank. Visscher and Vetter allowed honeybees to sting them, 20 times each, and compared the two methods of stinger removal. They found no difference in welt size.

``This matters,'' Visscher said, ``because when people get stung, they will spend time thinking what was I supposed to do, and looking for the proper tool.''

All that time, venom is being pumped into the wound. So, Visscher and his colleagues urge, do not hesitate. Just pull out the stinger as fast as you can. Do not fumble for a pocket knife or credit card, or stop to think about technique. Grab that stinger and yank.

``This has been an ongoing debate for a long time,'' said Dr. David Golden, an allergist and assistant professor of medicine at the Johns Hopkins School of Medicine in Baltimore. The new study helps to resolve it, he said, but he cautioned that the data also confirmed other researchers' work showing that the venom is pumped out so quickly that a person must react almost instantaneously to make a difference.

Even then, the sting still will hurt, and a welt will form. That led the team to a second set of experiments, yet to be published, concerning what to put on the welt once the stinger is extracted. They tried various old favorites, including ammonia, mud, meat tenderizer and ice. None had any effect on the size of the welts.

But Camazine said ice might ease the pain a bit, even if it does not relieve the swelling. Anesthetic sprays and creams also might help temporarily, he said.

The only people who need medical treatment for bee stings are the 1 percent of the population who can quickly have a fatal reaction to even one sting.