General housecleaning measures, (e.g. vacuuming floors and surfaces), seldom reach where bed bugs hide. For this reason, repetitive vacuuming by occupants may not be worth the effort, especially compared to other important preparatory activities. Targeted vacuuming of bed bugs and infested harborages, however, can help remove some of the bugs before other treatment measures are undertaken. Bed bugs and especially the eggs can be difficult to dislodge. Optimum results will be achieved by moving and scraping the end of the suction wand along infested areas such as seams and fabric folds of beds and sofas, and the perimeter edge of wall-to-wall carpet. Bed bugs can survive the high speed trip down a vacuum, so it’s important to carefully dispose of the vacuum contents in a sealed trash bag afterwards. 
The effective use of pesticides for bed bug control typically involves a thorough inspection during which the technician will kill any bed bugs he/she discovers, applying contact or residual pesticides directly on the bugs. This is followed by residual application to all cracks, crevices and voids, likely to harbor bed bugs. The pesticide used should be one that remains active for weeks, allowing bed bugs that were missed on the initial inspection to contact treated surfaces long enough to receive a lethal dose.

It’s perfectly natural to want to eliminate a bed bug infestation without spending a ton of money on professional-grade products or a treatment by a pest control operator. When people discover that they have bed bugs, they often turn to do-it-yourself recommendations from discussions on the Internet. These suggestions might include household items, some of which are recommended more often than others. Let’s take a closer look at some of the most popular items and how they might be used against bed bugs:
Pest management professionals are increasingly looking to heat to control bed bugs. Whole houses and, in some cases, multi-unit structures are heated to temperatures well above those lethal to bed bugs, to help assure uniform heating of household contents. Rooms must be heated for several hours during which bulky contents are turned to help ensure heat penetration deep enough to kill bed bugs hiding inside.
DIY heat treatments most often just drive bed bugs deep into wall voids and hard-to-reach spaces in a structure. When the heat is turned off, the bugs return to living and sleeping areas. It has no impact at all. But, in worst case scenarios, where desperate people have gone to greater lengths to destroy these tormenting pests, it has resulted in damage to belongings, the death of pets, structural fires, and in tragic cases, a loss of human life.
You’ll likely only see them in their hiding spots or crawling across the floor since, unlike other insects, bedbugs cannot fly or jump. Durham says to check along the edges of your mattress. You may see the exoskeletons that bedbugs have shed as they matured, or you may notice a musty smell, both of which indicate there could be bedbugs in the area. It can also be helpful to check your bed with a flashlight during the middle of the night (since these crawlers tend to be more active at night.)
Checking beds for bed bugs was a common practice long ago, especially while traveling. Travelers today should consider doing the same, preferably before unpacking. This would entail examining the bed sheets and seams of the mattress and perhaps box spring for signs of bed bugs, especially along the head (pillow end) of the bed. Experts also remove and check behind headboards since this is a frequent hiding place for bed bugs in hotels. Headboards are heavy and cumbersome, however, and untrained persons should not attempt removal themselves.
Insecticide Application This is the most common way to get rid of bedbugs, Lazarus says. Oftentimes, the professional will use several different products to effectively treat the area, though it may take a few rounds to ensure removal. “The advantage to this method is that the residual insecticide will continue to offer protection for a period of time,” Lazarus says. “The biggest drawback is that the preparation for service is time-consuming and must be repeated prior to each service.”
Bed bugs have been pestering humanity for thousands of years, but in the 1950s they finally met their match: the pesticide DDT. Then DDT was banned, but for most of the 40 years since, bed bugs have not been a major problem. Now, however, these blood-sucking vermin are back with a vengeance. That’s the bad news. The good news is that, unlike mosquitoes and ticks, bed bugs don’t spread disease, and there are practical steps you can take to prevent an infestation. And if you do get bed bugs, you can get rid of them yourself. We’ll show you what to look for, how do you get rid of bed bugs if you find them, and how to keep them out!
They also have the ability to travel beyond the bedroom, so all adjoining rooms should be checked for infestation. Any area that offers a layer of protection, e.g. dark, isolated areas, should be checked. They do leave excrement droppings behind, so even if they are not seen, you can often see where they have been. The best method to find them is to check only at night, and with a red light.
Occasionally, you might find other bugs which resemble the common bed bug including the bat bug and swallow bug. Both of these species superficially resemble the common bed bug. However, their primary hosts are bats and birds and there are small but diagnostic morphological differences. Problem infestations with these bugs may occur in attics or unused chimneys. Typically, when one host is gone these bugs seek an alternative host blood meal. This is when humans are bitten. It is important to differentiate between the common bed bug and other bugs that feed on bats and birds because control efforts can be targeted at the wrong sites and infestations can continue.
The type of reaction provoked depends on previous exposure; repeated bites may lead to an allergic reaction, which may lead to pronounced cutaneous manifestations. Some patients show a severe systemic hypersensitivity to arthropod allergens. The site of the bite can also become secondarily infected with bacteria infection and lead to ecthyma, cellulitis, and/or lymphangitis.
Isolating your bed from the rest of the house.  If you don’t use a bed, purchase a frame that gets your mattress off the floor and install bed bug interceptors under all feet of the bed frame to keep bed bugs off your bed while you are sleeping. Interceptors are special platforms or cups that are purchased to prevent bed bugs from climbing on to your bed.  An interceptor can be as simple as a sticky card placed under a bed post (sticky and messy).  Better are one of the commercial pitfall traps made specifically for this purpose.  The Climbup™ Bed bug Interceptor and BlackOut BedBug Detector (Google them) are two such products sold online. Relatively inexpensive, these cups trap bed bugs attempting to climb (or exit) the bed. If you have encased your bedding, treated your bed frame thoroughly and installed interceptors, you will be instantly protected against bed bugs.  Don’t take out your clean bedding or put it back on the bed until the bed has been treated (and dried) and encasements installed. And note that for this method to be effective, beds and bedding must not touch the floor, furniture or walls.  This would provide bed bugs other ways to climb onto the bed and foil your defenses. 

You can check bedding, mattresses, furniture, and crevices in walls for bed bug infestation. Do your inspection just before dawn, which is when they are the most active. The bugs will be larger and slower after feeding. Bedbugs will quickly flee from light, so live bugs are best located in the folds and seams of mattresses and sheets. Bedbugs are about the size of an apple seed, about 1/4 inch long. They change from light brown to purple-red after feeding. You may also see their eggs, which are about the same size as the adults. The eggs will often be in seams, cracks, or crevices.
To know it's bedbugs, it's important to find the bugs themselves. Look at bedsheets and mattresses for little spots of blood, rusty-looking stains (crushed bugs), or black dots (bugs' poop). You might see live bugs around the seams or tags of mattresses and box springs, or in cracks of bed frames and other furniture. They can even hide in books, carpet edges, and electrical outlets.
Next, apply a bed bug powder into confined areas where it won’t be stirred up into the air. Places like the edges of carpeting, inside deep cracks and wall voids, and inside electrical outlets and light switches (accessed by removing the faceplate with a screwdriver) are good candidates for powders, as sprays can’t reach into these areas quite as well. We recommend using a professional powder applicator, which offers better control when applying the powder.
Bed bugs have five immature nymph life stages and a final sexually mature adult stage.[13] They shed their skins through ecdysis at each stage, discarding their outer exoskeleton.[14] Newly hatched nymphs are translucent, lighter in color, and become browner as they moult and reach maturity. Bed bugs may be mistaken for other insects, such as booklice, small cockroaches, or carpet beetles; however, when warm and active, their movements are more ant-like, and like most other true bugs, they emit a characteristic disagreeable odor when crushed.

Start in the corners and along edges of an open wall.  With the card, see if you can dig things out of the cracks and crevices. Work your way along the cracks and crevices. For example, if you are checking a baseboard along the floor, see if you can get the card between the baseboard and the floor, as well as the top of the baseboard and the wall. If you have a bare tile or wood floor, consider using a damp cloth or map to wipe the floor.  Don’t use too much water as floors can be slippery.  Look for anything moving after you wipe the floor. If you have carpeted areas vacuum the clean area. See Vacuuming Items to Capture Bed Bugs.  Don’t forget to check pictures and other items on this wall.

Dust the wall voids. Bed bugs can often travel from room to room, especially in apartments, hotels and condo's. They travel along electrical wiring and plumbing lines. Specifically treat wall voids with a hand duster either by removing wall switch plate covers and/or drill access holes discreetly between studs. Cimexa Dust or Delta Dust are excellent choices for void applications. It kills populations in walls and voids and creates a repellent, hostile environment which reduces the likelihood of bed bugs traveling through voids to other areas. Use a small hand type duster to "puff" insecticidal dusts into these areas. A light coating is all that is needed. To much dust and the bed bugs will just crawl around it.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
To treat an allergic reaction, the doctor may prescribe an antihistamine, corticosteroid, or epinephrine injection. If the area is infected, he or she might prescribe an antibiotic or recommend an over-the-counter antiseptic. Finally, if it’s severe itchiness that you’re dealing with, applying corticosteroid or taking an antihistamine in pill or liquid form may be able to help.
Discourage bed bug infestation by keeping clutter picked up, washing bedding and upholstery routinely and not buying used furniture. When you’re traveling, lower your risk of bringing bed bugs back home by opening your suitcase on a hotel desk or luggage rack instead of on the bed; keeping your belongings in your suitcase, not unpacked in dresser drawers; sealing dirty laundry in plastic bags that can be taken straight to the laundry room at home; and inspecting your luggage for bed bug activity before you bring it into your bedroom.
Bring in only what is needed, and avoid sitting or placing coats and other items on beds, floors and sofas where the bugs commonly reside. Essential items can be placed on a tabletop or other hard surface, preferably away from bedrooms and sleeping areas. Better to sit on a hard (non-upholstered) chair than on sofas and recliners. Also try to avoid leaning or brushing against beds and upholstered furniture. If such items are carried out of infested dwellings (e.g., by sanitation workers or firefighters), it’s best to wrap them in plastic or at least not hold them against your body during transport. Emergency Medical (EMS) personnel may need to take additional precautions, such as removing a patient’s bed bug-infested shoes or clothing, or installing plastic sheeting before transporting them in the emergency vehicle.    
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