What is included in localized treatment of scorpion envenomation?

Updated: Nov 09, 2018
  • Author: David Cheng, MD; Chief Editor: Joe Alcock, MD, MS  more...
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Answer

Use ice bags to reduce pain and to slow the absorption of venom via vasoconstriction. This is most effective during the first 2 hours following the sting. Alternatively, hot water immersion has been described as a first aid treatment for scorpion bites in Australia and in Taiwan. [32, 33] A randomized controlled trial performed in Taiwan suggests that hot water immersion for Scolopendra bites is as effective as ice pack treatment in relieving pain.

Immobilize the affected part in a functional position below the level of the heart to delay venom absorption.

Calm the patient to lower the heart rate and blood pressure, thus limiting the spread of the venom.

For medical delay secondary to remoteness, consider applying a lymphatic-venous compression wrap 1 inch proximal to the sting site to reduce superficial venous and lymphatic flow of the venom but not to stop the arterial flow. Only remove this wrap when the provider is ready to administer systemic support. The drawback of this wrap is that it may intensify the local effects of the venom.

Apply a topical or local anesthetic agent to the wound to decrease paresthesia; this tends to be more effective than opiates and ice application. [34]

Administer local wound care.

Administer tetanus prophylaxis.

Administer systemic antibiotics if signs of secondary infection occur.

Administer muscle relaxants for severe muscle spasms (ie, benzodiazepines.)


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