Scorpions

These eight-legged arthropods, with a stinging tail and a pair of anterior pincers, have a shape both familiar and frightening to all. The 1,400 species live on all continents except Antarctica; the varied colors and sizes do not correlate with the danger of the sting, which varies from a local noxious event to a fatal event (38). When confronted by, or preferably before being confronted by, a scorpion sting, one should contact local emergency rooms to discover the danger posed by scorpions in the area.

Recent publications list as local symptoms pain, often severe, lasting for several hours, numbness, edema, parasthesia, and erythema (60-62). The area may be blackened by hemorrhage; as with vespids, a wheal may also be seen—anaphylaxis may complicate matters. A local anesthetic may be of use. Ice packs and pressure dressings often help (38). Systemic symptoms without permanent damage include vomiting, headache, paleness, sweating, myoclonus, dysarthria and ataxia (60-62). Seizures, pulmonary edema, and cardiac damage can also ensue and be fatal (60-64). Scorpion venom has specific cardiotoxicity (63,64), the treatment of which is controversial. Antivenom has been advocated (65) but is also controversial. As stated before, wise treatment depends upon local knowledge. A general statement will not apply in all areas; but, where appropriate, a conservative approach may be wisest consisting of 6 hours of monitoring followed by hospitalization if systemic symptoms appear (66).

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