Treatment for Scorpion Stings
For scorpion stings, first aid treatment should include over-the-counter acetaminophen or NSAIDs, topical lidocaine (if skin is intact), and ice application for pain relief, while monitoring for systemic symptoms that require emergency medical care. 1
Initial Assessment and Management
- Emergency services should be called immediately if the person develops systemic symptoms such as difficulty breathing, muscle rigidity, dizziness, or confusion 1
- Medical care should be sought if pain extends beyond the sting site, becomes severe, is not controlled by over-the-counter pain medications, if an open wound develops, or if systemic symptoms appear 1
- Most scorpion stings in North America cause only local symptoms, but severe local and systemic symptoms can occur, especially with bark scorpion (Centruroides) stings 1
First Aid Pain Management
- Over-the-counter acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) are recommended to alleviate local pain from scorpion stings 1
- Topical lidocaine (5%) can be applied if the skin is intact, which has shown significant pain reduction in clinical studies 1
- Ice application to the sting site is useful for local pain relief 1
- Local or regional nerve blocks with lidocaine may be used in medical settings for severe pain that doesn't respond to other measures 2
Special Considerations for High-Risk Populations
- Children are at higher risk for severe reactions to scorpion stings, particularly respiratory compromise from bark scorpion envenomation 1, 3
- Patients with severe systemic symptoms should be monitored in a healthcare setting where vital signs and cardiac function can be continuously assessed 3
- Time to treatment is critical - patients with severe toxicity often present to hospitals after a significantly longer delay compared to those with mild-to-moderate symptoms 3
What NOT to Do
- Do not cut the wound or attempt to suck out the venom 4
- Avoid applying tourniquets or constrictive bandages 4
- Do not administer steroids or antihistamines, as these have been associated with higher mortality rates in some studies 5
Advanced Medical Care
- For severe envenomation with systemic effects, particularly in children, specific antivenom may be administered in a hospital setting 6, 3
- Patients with acute pulmonary edema or cardiovascular complications may require intensive care management with vasopressors and respiratory support 6, 5
- Close monitoring in an intensive care setting is recommended for patients with severe envenomation, especially children 3