Scorpion venom contains many toxins as well as the chemical histamine.

This venom is found in scorpions and related species. More than 40 species of scorpions are found in the United States.

The class of animals to which scorpions belong contains the largest number of venomous species known.

Scorpion stings kill more people around the world than any other animal, except snakes (from snake bites). However, most varieties of North American scorpions are NOT venomous. The venomous ones in the United States live mainly in the southwestern deserts.

In mild cases, the only symptom may be a mild tingling or burning at the site of the sting.

In severe cases, symptoms in different parts of the body may include:

EYES AND EARS

• Double vision

LUNGS

• Difficulty breathing
• No breathing
• Rapid breathing

NOSE, MOUTH, AND THROAT

• Drooling
• Itching of the nose and throat
• Spasm of the larynx (voice box)
• Tongue that feels thick

HEART AND BLOOD

• Increased or decreased heart rate
• Irregular heartbeat

KIDNEYS AND BLADDER

• Inability to hold in urine
• Decreased urine output

MUSCLES AND JOINTS

• Muscle spasms

NERVOUS SYSTEM

• Anxiety
• Convulsions (seizures)
• Paralysis
• Random movements of the head, eye, or neck
• Restlessness
• Stiffness

SKIN

• Heightened sensitivity to touch in the area of the sting
• Sweating

• Abdominal cramps
• Inability to hold in stool
• Nausea and vomiting

Most stings from North American scorpions do not need treatment. Children 6 years and younger are more likely to have harmful effects from venomous types of scorpions.

• Clean the area thoroughly with soap and water.
• Place ice (wrapped in a clean cloth) on the site of the sting for 10 minutes and then off for 10 minutes. Repeat this process. If the person has problems with blood circulation, decrease the time that the ice is on the area to prevent possible skin damage.
• Keep the affected area still, if possible, to prevent the venom from spreading.
• Loosen clothing and remove rings and other tight jewelry.
• Give the person diphenhydramine (Benadryl and other brands) by mouth if they can swallow. This antihistamine drug may be used alone for mild symptoms.

Have this information ready:

• The person's age, weight, and condition.
• Type of scorpion, if possible. Take a photo of the scorpion if safe to do so, but do not risk additional injury from it.
• The time of the sting.
• Location of the sting.

Your local poison control center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. This national hotline will let you talk to experts in poisoning. They will give you further instructions.

This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.

Take the insect with you to the hospital, if possible. Make sure it is in a tightly closed container.

The health care provider will measure and monitor the person's vital signs, including temperature, pulse, breathing rate, and blood pressure. The wound and symptoms will be treated. The person may receive:

• Blood and urine tests
• Breathing support, including oxygen, tube through the mouth into the throat, and breathing machine (ventilator)
• Chest x-ray
• ECG (electrocardiogram, or heart tracing)
• Fluids through a vein (by IV)
• Medicine to reverse the effect of the venom
• Medicine to treat symptoms

Death from scorpion stings rarely occurs in people older than 6 years. If symptoms rapidly become worse within the first 2 to 4 hours after the sting, a poor outcome is more likely. Symptoms may last several days or longer. Some deaths have occurred as late as weeks after the sting if complications develop.

Scorpions are nocturnal predatory animals that usually spend the day under rocks, logs, or floors and in crevices. DO NOT put your hands or feet in these hiding places.

Curtis AM, Erickson TB. Venomous animal injuries. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 53.

James WD, Elston DM, Treat JR, Rosenbach MA, Neuhaus IM. Parasitic infestations, stings, and bites. In: James WD, Elston DM, Treat JR, Rosenbach MA, Neuhaus IM, eds. Andrews' Diseases of the Skin: Clinical Dermatology. 13th ed. Philadelphia, PA: Elsevier; 2020:chap 20.

Suchard JR. Scorpion envenomation. In: Auerbach PS, Cushing TA, Harris NS, eds. Auerbach's Wilderness Medicine. 7th ed. Philadelphia, PA: Elsevier; 2017:chap 44.

Updated by: Jesse Borke, MD, CPE, FAAEM, FACEP, Attending Physician at Kaiser Permanente, Orange County, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.