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Scorpion bite treatment

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WHO scorpion sting management antivenom clinical guideline

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scorpion envenomation treatment

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https://www.emro.who.int/emhj-volume-3-1997/volume-3-issue-1…

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A scorpion sting can be an emergency, especially in a child. Seek urgent medical care now if there is trouble breathing or swallowing, excessive salivation/sweating, vomiting, abnormal eye movements, muscle twitching or jerking, severe agitation, fainting, chest symptoms, fast/slow heartbeat, high fever, or worsening pain. Do not wait for symptoms to become severe.

First aid

  1. Move away from the scorpion and keep the person calm and still.
  2. Wash the site gently with soap and water.
  3. Remove rings, bangles, or tight footwear near the limb.
  4. Apply a cold pack wrapped in cloth for 10 minutes at a time. Do not put ice directly on skin.
  5. Use a usual pain reliever such as paracetamol/acetaminophen or ibuprofen if normally safe for the person.
  6. Get medical assessment promptly if the sting is in a child, older adult, pregnant person, or anyone with heart/lung disease, or if the scorpion may be a dangerous local species.
Do not cut or suck the site, apply a tight tourniquet, give alcohol or sedatives, use electric shocks, or rely on herbal remedies. Avoid food and drink if there is vomiting, drowsiness, or difficulty swallowing.

Hospital treatment

Most stings cause local burning pain only and are treated with analgesia, cold packs, wound care, and tetanus review. Dangerous species can cause autonomic and neurologic toxicity, including hypertension, arrhythmias, pulmonary edema, secretions, muscle activity, and respiratory failure.
Hospital care may include:
  • Continuous monitoring of breathing, oxygen level, blood pressure, ECG, and urine output
  • Oxygen, IV access, suction, airway support or ventilation if needed
  • IV fluids and targeted treatment of blood-pressure, heart, lung, or cholinergic complications
  • Benzodiazepines for severe neuromuscular agitation, with close respiratory monitoring
  • Species- and region-specific antivenom for clinically significant systemic envenomation, where it is available and appropriate
  • In India and nearby regions, clinicians may use prazosin for the catecholamine-mediated cardiovascular syndrome, with antivenom and intensive supportive care as indicated. This must be prescribed and monitored by a clinician, not self-administered.
Young children are at particularly high risk because the same venom dose is larger relative to body size. Harrison's Principles of Internal Medicine, p. 3778 notes that lethal scorpion species can produce respiratory arrest in young children and older adults; local-only stings generally resolve with symptomatic treatment. The WHO scorpion-sting report also emphasizes referral and observation when systemic toxicity is possible.
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