Scorpion Stings in Arizona: What to Do, and When to Come In

If you have just been stung, the short version is this: most scorpion stings in
Arizona hurt a great deal and settle over several hours. A small number are
genuinely dangerous, and the difference usually shows up within the first hour —
most often in a young child.

Either way you can come in, and with a child we would rather you did. What
follows is what to watch for while you decide.

What stung you, most likely

Arizona has about thirty species of scorpion, and only one of them is
regarded as life-threatening: the bark scorpion. It reaches only about an
inch and a half, straw-coloured to light tan, and is told apart from the less
toxic species by its more slender tail segments and pincers. It is easy to
miss against a wall or a tiled floor, which is part of the problem.

Bark scorpions are the best climbers of the Arizona species, and they are
inactive during the day — so they turn up in places the others do not: inside
a shoe left by the door, in bedding, in folded laundry, on a wall above head
height.

Most stings reported to Arizona's poison centre happen at night, during the
warm summer months. Around the West Valley they are simply part of living
here, and being stung is not a sign anyone did anything wrong.

What a normal sting feels like

For most adults, an uncomplicated bark scorpion sting produces:

• Immediate, intense pain at the site — often described as burning or electric
• Numbness and tingling that can spread up the limb
• Little or no visible swelling, and often no mark at all
• A patch of skin that feels painful to even light touch

It is disproportionate pain for an injury you frequently cannot see, and that
mismatch is normal. This kind of sting typically settles over several hours —
and if the pain is more than you want to sit with, or you would rather someone
looked at it, that is a good enough reason to come in.

Come in now if you see any of these

Bring the person in, or call 911 if they cannot travel safely:

• A child under about six years old was stung. Small children are the group
  most likely to become seriously ill, and the fastest. Do not wait to see how
  it develops.
• Eye movements that roam or flicker without the person controlling them
• Trouble swallowing, a thick-feeling tongue, drooling, or slurred speech
• Muscle jerking or twitching, or thrashing that the person cannot stop
• Difficulty breathing, or noisy breathing
• Agitation or inconsolable crying in a child who cannot be settled
• Vomiting repeatedly, or a racing heart
• Any sting where the person is very young, very old, pregnant, or already
  unwell

That list is not about how much it hurts. Severe envenomation is about the
nervous system, and severe pain alone is not the warning sign — the eye
movements, the swallowing, and the muscle jerking are.

A severe sting can be treated here. El Mirage ER is a full-scope emergency
room, so a child or adult with serious envenomation can be assessed and treated
without being sent somewhere else first. We are not a pediatric emergency room,
and we treat children every day — El Mirage and the cities around it have a lot
of young families, and scorpion stings in children are a large part of why.

If someone needs to be admitted to hospital afterwards, we stabilise and treat
them here and arrange the transfer. Most stings never get near that.

What to do in the first hour

1. Call the Poison Control Center: 1-800-222-1222. It is free, staffed
   around the clock, and Arizona's centre handles scorpion stings constantly.
   They will tell you whether to watch at home or come in, and they are the
   right first call for a sting that looks uncomplicated.
2. Wash the area with soap and water.
3. Use a cool compress on the site for comfort. Wrap it — do not put ice
   directly against skin, and take it off periodically.
4. Keep the limb still and level with the heart, rather than raised or
   dangling.
5. Take a simple pain reliever if the person normally takes one safely.
6. Watch the person, particularly a child, for the symptoms in the list
   above. Have someone stay with them.

What not to do

• Do not cut the site, or try to suck out venom. It does not work and adds a
  wound that can become infected.
• Do not apply a tourniquet or tight band.
• Do not use alcohol on the site or to cope with the pain.
• Do not prolong ice. Long applications on numb skin can injure it.
• Do not try to catch the scorpion. If it is already dead and safe to
  collect, it can be brought in, but nobody should be hunting a scorpion in the
  dark for identification. Treatment does not wait on it.

Keeping them out of the house

Bark scorpions get in through gaps, and they stay because the house offers dark
places and insects to eat.

• Shake out shoes, slippers and clothing left on the floor, and check
  bedding before getting in. This single habit prevents a lot of stings.
• Seal the gaps — weather-strip doors, screen vents, and caulk around pipes
  and conduits where they enter walls.
• Move the harbourage away from the walls: firewood, bricks, pavers, pots
  and yard debris.
• Reduce their food supply by dealing with crickets and other insects.
• Hunt with a UV light after dark. Scorpions fluoresce a bright blue-green
  under ultraviolet, which makes a cheap blacklight the single most useful tool
  for finding out whether you have them and where.
• Keep beds away from walls and off the floor where you can, especially a
  child's bed.

Frequently asked

Is a scorpion sting an emergency?
For a young child, or for anyone showing the nervous-system symptoms listed
above, treat it as one and come straight in. For a healthy adult the pain is
usually the whole of it — and you are still welcome here. Poison Control on
1-800-222-1222 can talk it through with you at any hour, and so can we on
(480) 237-4922.

How long does the pain last?
The worst of it is typically in the first few hours. Tingling and sensitivity in
the area can linger for a day or two, sometimes longer.

Should I go to the ER or call Poison Control first?
If the person has any of the warning signs, come in — or call 911. If it looks
like an ordinary painful sting, Poison Control first is reasonable, and they will
tell you if that changes.

What about my dog or cat?
Pets get stung too, and the vet or the ASPCA poison line is the right call — we
treat people.

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If a sting looks like more than pain, come in. El Mirage ER is open 24 hours
a day, 7 days a week at 12000 N El Mirage Rd, with no appointment and no
referral needed. If you are unsure, call us on (480) 237-4922 — and if the
person cannot travel safely, call 911 instead.

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Sources

The guidance in this article about when to seek emergency care is drawn
from these public sources. Each one is linked so you can read it yourself.

• Arizona Poison and Drug Information Center — Scorpions — https://azpoison.com/venom/scorpions
• Poison Control (National Capital Poison Center) — Poison Help, 1-800-222-1222 — https://www.poison.org/

This article is general information, not a diagnosis, and it cannot account
for your history or medications. If you are unsure, call us on (480) 237-4922
or come in. If it might be an emergency, treat it as one and call 911.