Know about Scorpion Stings

Introduction: A nocturnal arachnid that lives in the Southwest of the United States is the scorpion. It has two venom glands and a stinger in its tail. The majority of species are rather benign, and they often only create a limited reaction similar to that brought on by a bee sting. 

The bark scorpion (Centruroides sculpturatus) venom, on the other hand, has neurotoxic that can result in a serious reaction. This dangerous scorpion is found on trees in Arizona and New Mexico.

CLINICAL FEATURES

1. Local effects: The C. sculpturatus scorpion bite causes immediate, excruciating pain at the stung site, as well as swelling and ultimately, numbness. The area that was hurt is extremely sensitive, and the implicated extremity could become paralyzed.

2. Systemic effects: The neurotoxin is strongly cholinergic and can cause excessive salivation, blurred vision, muscular spasms, hypertension, and respiratory difficulties.

DIFFERENTIAL DIAGNOSES 

— Snakebite

— A puncture wound or other trauma

— Insect or spider bite

— Drug intoxication

EVALUATION: Typically, the offending scorpion is seen or assumed by history; if safety allows the scorpion to be brought in, this is best. Due to the wide range of symptoms and quick progression, a thorough history and physical examination are necessary.

THERAPY

1. Pre-hospital management includes rapid transportation of the patient, application of an ice pack to the sting site, and safe transport of the scorpion for identification. When serious symptoms appear, life-saving procedures should be started.

2. ED management

a) Antivenin should be administered in all cases of severe envenomation.

b) Ventilatory support may be required, with intubation and oxygen for patients with severe systemic response or anaphylaxis.

c) Atropine may be required to counteract the cholinergic effects; the dose is titrated to relieve the cholinergic signs.

d) Benzodiazepines may be used for seizures and muscle spasms.

DISPOSITION: All victims should be observed for 24 hours, especially children. Symptomatic patients should be transferred to the intensive care unit if symptoms are severe.