Treatment for Scorpion Stings
The recommended treatment for scorpion stings includes immediate pain management with over-the-counter medications like acetaminophen or NSAIDs, application of ice to the sting site, and seeking medical attention if systemic symptoms develop. 1
Initial Assessment
- 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
- 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
First Aid and Pain Management
- Over-the-counter acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) are recommended to alleviate local pain from scorpion stings 1
- Ice application to the sting site is useful for local pain relief 1
- Topical lidocaine (5%) can be applied if the skin is intact, which has shown significant pain reduction in clinical studies 1
- For severe localized pain, a local or regional nerve block with lidocaine may provide immediate relief, as demonstrated in case reports 2
Advanced Treatment for Severe Envenomation
- Patients with systemic symptoms require close monitoring in an intensive care setting with continuous cardiac monitoring 3
- Specific antivenom is recommended only for cases with systemic manifestations, particularly in children 2, 3
- Severe cases may require supportive care including vasopressors, hydration, and respiratory support 4
- Protocol-guided therapy using specific medications like prazosin has shown significant reduction in mortality in pediatric cases with severe envenomation 5
Follow-up Care
- Most patients with local symptoms only will recover completely within 24-48 hours 1
- Continued pain management with over-the-counter medications may be needed for several days 1
- Any signs of secondary infection at the sting site require prompt medical attention 1
Common Pitfalls to Avoid
- Delaying medical care when systemic symptoms are present can lead to increased morbidity and mortality 3
- Cutting the wound or attempting to suck out the venom is contraindicated and may worsen outcomes 6
- Administration of steroids and antihistamines without appropriate supportive care has been associated with higher mortality in children 5
- Underestimating the severity of envenomation based solely on local findings at the sting site can lead to delayed treatment of potentially life-threatening complications 3