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Scorpion Sting

The effects and excruciating pain of a scorpion sting can never be underestimated, especially on young children. What follows is a real-life account from the father of a nine year old girl who was recently stung by a scorpion at Argyle Boma:

“35 hours after the incident in Argyle boma and with high level medical management Olivia continues to experience twitching, involuntary muscle movements and is not making sense whilst sleeping & in half sleep. I am writing this by her side; her signs are good now though, the pulse rate, temperature and general signs are all good. We have not been able to pin point the cause until some extensive reading that I have now done early this morning. I think I may have been able to match all of the symptoms since the incident right up until now to the Parabuthus transvaalicus scorpion. This is the lightcolouredscorpion with the relatively thick tail and slender pincers, as you probably well know.

The learning from this incident is as follows;

  • In children this is most commonly caused when barefoot at night, but note my comment on slip slops further down. Olivia was wearing sandals most of the time, but at the actual time of the incident may have "slipped off" which is what happens with slip slops and sandals. Olivia climbed off the slab in the left hand side of the boma flicking her sandals off.
  • There is excruciating pain immediately, for some time and up to a day thereafter at the sting point.
  • The actual signs of the sting are "unimpressive", a short while after the sting and long after.
  • The first signs after the pain are local paraesthesia and pronounced hyperaesthesia.
  • Within minutes systemic envenomation took place in Olivia and after 40 minutes en-route to the control gate she was experiencing shock and the sensation of movement of the venom shot up her leg into the groin.
  • The frightening feeling continued as the envenomation continued up through the body giving intense muscle cramps followed by difficulties breathing and pain in the back.
  • According to this article there is a 20% mortality in children caused by respiratory failure usually due to delayed medical response.
  • The restlessness and twitching continue after 35 hours as we have not used antivenom yet.
  • The most common after effect is characterisedby crying and screaming and uncontrollable jerking, flailing and writhing as well as mouth & jaw movements that you would associate with tetanus.
  • There are sensations around the head and face that continue at 35 hours.

What is interesting to note that with all of these symptoms no practitioner at this facility has yet pinpointed the scorpion as the definite cause.

 As a result many other avenues have been exhausted including a traumatic lumber puncture on Olivia yesterday morning, blood tests for malaria, blood cultures and an antibiotic drip to counter infection brought about by fever, increased pulse rate and other symptoms which are all directly linked to what you will read here on the Parabuthus sting.

I am with Olivia now and have been able to explain to her what has happened. Olivia has said that she is scared for this to happen to any other children.

I would therefore recommend that with the holidays an increased use of places like bomas and platforms, but in particular Argyle boma where there is a very good chance that this particular scorpion is present, that we warn all members to be very careful there and make sure that children wear shoes at night. Most children are either barefoot or wearing slip slops, but the sting can easily flick around the side of the slip slop if the scorpion is trodden on.
 
This has certainly been a traumatic experience which is still by no means over as we are still in ICU and have more decisions to make.
 
We were met by Tamryn and her colleagues (2 trauma ambulance vans) at the R40 Guernsey gate. After doing a quick assessment of Olivia she was transported with Linda by her side in the ambulance and I following to Tzaneen Mediclinic which we decided was the quicker option than Nelspruit.
 
Around 40 minutes after leaving Hoedspruit and at around 10 pm Olivia started experiencing real breathing problems & the ambulance had to speed up dramatically for Tzaneen.
 
The timing of getting to a competent medical facility has been key and this would count for snake bite and most other trauma incidents this far away from hospitals.”


http://www.cmej.org.za/index.php/cmej/article/view/2545/2580 
The above link is well worth the read and provides excellent educational literature on scorpions, identification and how to manage a scorpion sting.

You can also read about scorpions on this website here
 
In addition, please consider purchasing ultra violet torches, for easy detection of scorpions. They can be purchased at most outdoorcentre sand 4x4 shops. Ingwelala will also endeavor to sell them in the Shop.
 

 

by John Llewellyn