A patient stung by a bee develops hives and chest tightness. What is the immediate treatment?

In the scenario where a patient experiences hives and chest tightness following a bee sting, the immediate treatment is the administration of subcutaneous epinephrine. This is because the symptoms suggest an anaphylactic reaction, which is a severe and potentially life-threatening allergic response.

Epinephrine is the first-line treatment for anaphylaxis as it works quickly to alleviate the symptoms by causing vasoconstriction, bronchodilation, and reducing vascular permeability. These actions help to increase blood pressure, reduce swelling, and improve airway patency, thereby addressing critical symptoms such as chest tightness and respiratory distress.

While transferring the patient to a hospital may be necessary for ongoing care, it is not an immediate treatment. Applying a cold compress may help with local symptoms but is insufficient for systemic reactions like anaphylaxis. Oral albuterol may be useful in addressing bronchospasms but does not provide the rapid response needed for life-threatening anaphylactic symptoms. Hence, the administration of subcutaneous epinephrine is the appropriate and immediate intervention in this case.