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

Emergency & clinical flowcharts


Signs and symptoms1  

Emergency medical treatment


Possible cause


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)

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.



  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


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?".