Definition
The American Association of Poison Control Centers annually receives thousands of reports of scorpion stings. Many of those scorpion stings — although painful — are probably harmless. Of the approximately 90 species of scorpions in the United States, only the bark scorpion — found mainly in the desert Southwest — has venom potent enough to cause severe symptoms. In other parts of the world, however, scorpion stings are often the cause of serious injury and death.
Scorpion stings are most serious in young children, older adults and pets. In America, healthy adults usually don't need treatment for scorpion stings, but if your child is stung, always get immediate medical care.
Symptoms
Most scorpion stings in the United States cause only minor symptoms, such as pain and warmth at the sting site. The venom of the bark scorpion, which is native to Arizona, New Mexico and the California side of the Colorado River, is more toxic and can be life-threatening in children.
Signs and symptoms in children who have been stung by a bark scorpion include:
Pain, which can be intense, numbness and tingling in the area around the sting, but little or no swelling
Muscle twitching or thrashing
Unusual head, neck and eye movements
Drooling
Sweating
Restlessness or excitability and sometimes inconsolable crying
Adults are more likely to experience:
Difficulty breathing
High blood pressure
Increased heart rate
Muscle twitching
Weakness
When to see a doctor
It's always best to be safe. If you or your child is stung, follow these guidelines:
Get immediate medical care for any child stung by a scorpion.
If you've been stung, get prompt care if your symptoms become worse or new symptoms develop within a few hours of the sting.
If you're concerned about a scorpion sting — even if your reaction is minor — call your local poison control center for advice.
Seek medical attention right away if you or your child is stung while traveling in another country.
Causes
Scorpions are arthropods — a relative of insects, spiders and crustaceans — and have changed little in the last 400 million years or so. Although approximately 1,400 species of scorpions exist worldwide, only about 25 have venom potent enough to be hazardous to humans. The most dangerous scorpions are found in North Africa, the Middle East, South America and Mexico.
The average scorpion is about 3 inches long, but different species can be much smaller or larger. At 8 inches, the African scorpion is probably the world's longest. Scorpions have eight legs and a pair of crab-like pinchers, giving them a certain fierce look. The venom is carried in a gland on the back of the tail, and when on the attack, a scorpion can flick its stinger over its head with lightning speed. The venom itself contains as many as 30 toxins that affect the nervous system (neurotoxins), each of which is effective on a different type of prey.
Many people think of scorpions as dangerous pests, but they play a critical role in the ecosystem, consuming large quantities of other arthropods and even small snakes and mice. They're also shy, nocturnal creatures who resist stinging unless provoked or attacked. They can control the amount of venom they release — depending on how threatened they feel — so some stings may be almost entirely venomless.
Risk factors
Scorpion stings are increasingly common in endemic regions. According to the Arizona Poison Control Center, at least 5,000 people are stung each year in Phoenix, Tucson and other metropolitan areas in the state, primarily because residential building has expanded into the scorpion's native habitat.
No matter where you live, however, certain factors can increase your risk:
Season. Scorpions are most active in spring and summer, when nighttime temperatures hover above 70 F.
Location. In the United States, scorpions mainly inhabit the desert Southwest. Worldwide, they're found most often in North Africa, Central America, South America, the Middle East and India. Scorpions are adaptable, and they've also been discovered in the Himalayas and Hawaii.
Environment. Bark scorpions live under rocks, logs and tree bark — hence, the name — and you're especially likely to encounter them when you're hiking or camping. But they're also the most common house scorpion, hiding in firewood, garbage pails, bed linen and shoes.
Travel. Not only are you more likely to encounter dangerous scorpions while traveling in developing countries, you might also bring them home with you. Scorpions can hide in clothing, luggage and shipping containers.
Complications
As with stinging insects, such as bees and wasps, you can have an allergic reaction to a scorpion sting — sometimes severe enough to be life-threatening (anaphylaxis). Signs and symptoms are similar to those of bee stings and can include hives, trouble breathing, and nausea and vomiting. An allergic reaction may be wrongly attributed to the venom, which can cause different, but also dangerous, symptoms.
The very old and the very young are most likely to die of untreated venomous scorpion bites. The cause is usually heart or respiratory failure occurring some hours after the sting, although there have been no deaths from scorpion stings in the United States in decades.
Preparing for your appointment
If you can find the scorpion that stung you or your child, bring it with you to the hospital. Identifying the type of scorpion may make treatment easier.
Tests and diagnosis
Your history and symptoms are usually all that your doctor needs to make a diagnosis. If you have severe symptoms, you may have blood or imaging tests to check for the effects of the venom on your liver, heart, lungs and other organs.
Treatments and drugs
Most scorpion stings don't need medical treatment. Until recently, a serum that neutralizes venom (antivenin) was available to treat the most severe cases in Arizona. Derived from goat blood, the antivenin had one major drawback: It contained animal proteins that could cause a potentially life-threatening reaction. A new, protein-free antivenin produced in Mexico is currently being tested in several Arizona hospitals.
Lifestyle and home remedies
If a scorpion stings you or your child, follow the suggestions below. Healthy adults may not need further treatment, and these tips can help keep children safe until they see a doctor:
Wash the wound with soap and water.
Apply cold compresses to the affected area to ease the pain and slow the venom's spread. This is most effective in the first two hours after a sting occurs.
Try to stay calm and quiet so that the poison spreads more slowly.
If available, apply a cortisone cream or antibiotic ointment.
Don't consume food or liquids — stings can cause throat swelling and difficulty swallowing.
Avoid using narcotic pain medications, which can suppress breathing.
Prevention
Scorpions tend to avoid contact. To prevent chance meetings:
Remove trash, logs, boards, stones, bricks and other objects that would make good hiding places for scorpions from around your home.
Keep grass closely mowed, and prune bushes and overhanging tree branches, which can provide a path to your roof for scorpions.
Store garbage containers in a frame that allows them to rest above ground level.
Caulk cracks, install weatherstripping around doors and windows, and repair torn screens.
Avoid storing firewood inside your house.
Always wear shoes outdoors, especially around water sources, such as swimming pools and fountains.
Shake out your shoes and clothing before wearing them, in areas where scorpions are common.
When hiking or camping, wear long sleeves and pants and check your sleeping bag and clothing for scorpions every evening.
When traveling in other countries — especially if you're camping or staying in rustic accommodations — shake out your clothing and bedding often and sleep under a mosquito net. If you have a known allergy to insect stings, carry an epinephrine injector, such as EpiPen.
Carefully move a scorpion. If you find a scorpion near your home or campsite, don't panic. Use tongs to gently remove the scorpion to a safer location.
