Australian Scorpion

Australian Scorpions – bizarrely are less dangerous then those found elsewhere in the world. Current evidence would suggest they usually cause temporary pain and minor systemic symptoms only. Interestingly the smaller the scorpion the more painful the bite is.

Resus

  • Not life threatening

Risk Assessment

Typical symptoms include:

  • Pain at sting site can be severe and lasts up to 24 hours but usually has resolved by 6-12 hours.
  • Other local features include erythema, mild swelling and numbness.
  • Systemic symptoms can occur in 10% of patients and are listed to nausea, headache and malaise

Supportive Care

  • 1. Analgesia – Simple analgesia such as paracetamol and ibuprofen along with ice are good for initial first aid. If this is inadequate then opiates such as morphine 0.1 mg/kg has been used to good effect.
  • 2. PBI dressings are not required

Investigations

  • Not required

Differential Diagnosis:

  • Many spiders, bees, wasps, ants and even centipedes in Australia can cause a similar presentation. Of note it would be prudent not to miss a Funnel-web spider envenomation characterised by a painful bite, sweating, agitation, pilorection, cardiovascular abnormalities and neurological changes

Antivenom

  • Not available

Disposition

  • As a general rule patients do not usually require a hospital admission unless pain is an issue.

References:

  • Isbister GK, Polschenk ES, Bali CR et al. Australian Scorpion stings: a prospective study of definitive stings. Toxicant 2003; 41:877-883

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Dr Neil Long BMBS FACEM FRCEM FRCPC. Emergency Physician at Burnaby Hospital in Vancouver. Loves the misery of alpine climbing and working in austere environments. Supporter of FOAMed, toxicology, tropical medicine, sim and ultrasound

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