Treatment of scorpion stings
Dr. Stahnke recommends the following treatment for a person stung by one of the deadly scorpions:
“First, apply a tight tourniquet near the point of puncture and between it and the heart.... As soon as possible, place an ice pack on the site of the sting. Have a pack of finely crushed ice wrapped in as thin a cloth as possible. Cover and surround the area for about 10 to 12 inches. After the ice pack has been in place for approximately 5 minutes, remove the tourniquet.
“If a person is stung on the hand, foot, or other region that can be submerged completely, place the portion, as soon as possible, in an ice-and-water mixture made of small lumps of ice (about half the size of ice cubes) in a proportion of half ice and half water. Treatment should not be continued longer than 2 hours.
“NEVER put salt in the water. After the first 15 minutes, the hand or foot must be removed for relief for 1 minute every 10 minutes in the iced water.”
Dr. Stahnke continues: “If the patient is less than 3 years old, if the patient has been stung several times, or if the patient has been stung on the back of the neck, anywhere along the backbone, or on an area of deep flesh like the buttock, thigh, or trunk of the body, or especially on the genital organs, medical assistance should be obtained at once.”
Dr. F. A. Shannon advises that no person with disease involving the circulation of the extremities should use iced water. Morphine is a necessary tool in controlling pain, and barbiturates are useful for control of convulsions.
Several hospitals in southern Arizona keep a supply of scorpion antivenin and, in any case, the patient should be taken to a hospital as quickly as possible. In all cases the first-aid treatment should be applied and maintained until the patient is under the care of a physician.
With adults, in case a physician is not available, the iced-water treatment usually proves sufficient. Generally, after 2 hours of iced-water use, there is no longer any danger, but should symptoms reappear, treatment should be resumed.
Scorpion antivenin for stings of Centruroides sculpturatus and C. gertschi is available at the Poisonous Animals Research Laboratory, Arizona State University, Tempe, Arizona. The recommended method of treatment is the “L-C” method. The L stands for ligature and C for cryotherapy (tourniquet and ice pack treatment).
Treatment is as follows: “As soon as possible (after the sting has been received) inject intramuscularly or subcutaneously, 5 to 10 cc. of natural serum or 3 cc. of the concentrated. In serious cases, inject intravenously.” No immediate untoward results have been noted, but some cases of skin irritation develop later.
In cases of scorpion poisoning when antivenin is not available, the following treatment is recommended[12]:
“Use morphine with extreme caution. It has not been found effective in the usual doses. Barbiturates are more effective and less dangerous. Bromides in large doses are apparently of value. In those cases characterized by severe pulmonary edema (accumulation of fluid in the lungs) atropine is indicated along with general supportive measures. Compresses, using a fairly concentrated ammonium hydroxide solution, have been found helpful if applied within a few moments. If applied for the first time about 10 minutes after the sting, no apparent benefit is attained.”