The image of a scorpion, brandishing its terrible tail, is vivid in the minds of almost everyone. It is a well-known fact that a scorpion sting can be deadly to human beings. India, Mexico, Iran, and Tunisia are among the countries which see most scorpion-sting human fatalities.

There are over 1,500 species of scorpions and 300 of these can deliver deadly stings to humans. There are 86 species found in India but only two of these can be harmful to people.

The scorpion varieties found in India are: Hottentotta tamulus (Mesobuthus tamulus or Indian Red Scorpion) and Heterometrus species (Palamneus gravimanus or Indian Black Scorpion).

The size of the scorpion ha nothing to do with its sting or poison. The red scorpion is 2-4 cm in size and the black, 2-20 cm. The red scorpion is more deadly. It is a common misconception that the larger black ones are more poisonous.

The poison sack

The scorpion holds its poison in the telson region of its tail. The poison enters an external body through sting and not through bite.

Dwelling

Scorpions prefer darker places and they are found in the barks of trees, in heaps of wood, inside crevices, window panes, and even inside shoes.

Types of sting

Scorpion stings need not always be poisonous. They are capable of ‘dry stings’ which deliver no poison. This is only for self-defence. Once the poison enters the subcutaneous tissue (under the skin), almost 70 per cent of the poison spreads in the body in the next 15 minutes. Almost 100 per cent spread happens in seven to eight hours.

The scorpion’s poison has several chemicals in it. Phospholipase, acetylcholine esterases, hayluronidase, serotonin, neurotoxin 1 - 4 are some of those. Neurotoxin 1 - 4 enters the blood stream and produces catecholamine and acetylcholine, causing illnesses.

Indicators

The following are the indications of a poisonous scorpion sting.

» Severe pain and colour difference in the bite region

» Numbness in the limbs and around the mouth

» Excess saliva formation

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» Abdominal pain, loose motion, vomiting

» Profuse sweating

» Swelling in the bite region and possible necrosis (death of tissues)

» In children, a condition called priapism is observed. This causes the painful enlargement of the genitals.

» There could be the erratic beating of the heart and blood pressure variation

» In some people, seizure and stroke too are observed

Some patients quickly face acute respiratory distress syndrome (ARDS) may need ventilator support.

First aid and care

As in all cases, panic can only aggravate the situation.

» Reassure the victim. Increased agitation will hasten the spread of poison

» The affected part should be kept immobile as much as possible

» Do not try unscientific methods like bleeding out the wound

» Do not try oral extraction. It can only poison another person

» Constricting the blood flow using tourniquet or rope is not to be done

» Use ice packs. This will help reduce pain

Treatment

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» Finish initial examinations swiftly

» Adrenalin injections should be given if the victim is allergic to scorpion poison

» A local anaesthesia, paracetamol, or opioid medicines could be required in case of unbearable pain

» The victim should be under constant cardiac observation

» The medicine prazosin is usually given

» In some cases, AScV or antiscorpin venin is given

» AScV is usually given to children under 10 years of age

» Those who report hallucinatory behaviour may require diazepam or haloperidol

Prevention

The following may be done to keep scorpions away:

» Keep the surroundings neat and clean

» Avoid heaping of wood, bricks, etc

» Always check shoes before wearing it. (Do not put one’s hands inside to check)

» Check pillows and bedsheets before use

» Use adequate lights while operating in generally dark places like stores and dump yards

» If the door sill is high enough, the chances of scorpions entering the house is low

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» Fill the crevices on the wall

Scorpion stings are relatively lower than snakebites in Kerala. If you find a scorpion, one should be aware that there could be more in the place. So, exercising caution is the best way out.