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Poisonous animals
 
Cnidarians (Jellyfish, Corals and Anemones)
 
Venomous fish
 
Scorpions
 
Spiders
 
Hymenopterans (Bees, Wasps and Ants)
 
Sea snakes
 
Terrestrial snakes
 
Miscellaneous animals
 
 
 
 
 
 
 
 

Emergency & clinical flowcharts

 

Signs and symptoms1  

Emergency medical treatment

  Region  

Possible cause

  Antivenom2
           

Transient cholinergic effects:
vomiting, profuse sweating, hypersalivation, increased bronchial secretion, priapism, bradycardia, arterial hypotension (see Diagnosis & Treatment: Hospital)

 

Longer-lasting adrenergic effects:
tachycardia, arterial hypotension, pulmonary oedema, (cardiogenic + ?non-cardiogenic component), hyperglycaemia, hypertensive encephalopathy, myocardial failure, shock; acute pancreatitis
(see Diagnosis & Treatment: Hospital)

Neuromuscular dysfunction:
cranial nerves: "wandering" eye movements, dysphagia, dysarthria, pharyngeal reflex absent;
skeletal musculature: involuntary movements, restlessness, reduced grip and pinch strength
(see Diagnosis & Treatment: Hospital)

      Caution: avoid the use of atropine whenever possible (see Diagnosis & Treatment: Hospital)

Vasodilators:
hydralazine, nifedipine (see Diagnosis & Treatment: Hospital),
α-blockers (prazosin) (see Diagnosis & Treatment: Hospital),
ACE inhibitors (see Diagnosis & Treatment: Hospital);
caution with fluid replacement (see Diagnosis & Treatment: Hospital);
caution with diuretics (see Diagnosis & Treatment: Hospital)

Maintain the airways, endotracheal intubation, artificial respiration

Contraindicated or to be avoided: pethidine, morphine, barbiturates, atropine, calcium, anti-inflammatory drugs, including corticosteroids, digitalis
  India   Hottentotta thamulus
  MAVIN Antivenom index
 

North Africa, Middle East

 

Androctonus sp.

Leiurus quinquestriatus

Buthus sp.

 
 

Brazil,
Trinidad

  Tityus sp.
 
 

Mexico, southern USA

  Centruroides sp.
 
  Southern Africa
  Parabuthus sp.
 
           

Local pain, redness, oedema
(see Diagnosis & Treatment: Hospital)

  Infiltration with local anaesthetic (xylocaine 1%, max. 0.5 ml, without the addition of a vasoconstrictor);
regional nerve block anaesthesia
 

Numerous regions throughout the world

   All scorpions
   

 

1
See also the Clinical flowchart as a guide to the dynamics of envenoming.
2 Assessment of the importance of antivenom in the treatment of scorpion stings is very controversial (see Diagnosis & Treatment: General practitioner / health post). If clinical information regarding the efficacy of an antivenom is available, it is presented in the relevant Biomedical database entry. See "Essentials of the management of envenoming and poisoning: 9. How is the appropriate antivenom chosen? When is it administered?".