Scorpion Stings and Snake Bites
By Robert H. Page, MD and Curtis P. Page, MD

      Scorpion (Alacrán) Stings
      Of the more than 1,000 species of scorpions worldwide, only 30 carry a toxin that may be fatal in humans. In the U.S., the rate is very low: one death from a scorpion sting occurs on average every two to three years. In Mexico, there are a reported 1,000-2,000 deaths per year. Because of their size and ability to travel in shoes and luggage, scorpions are found in many ports all over the world, having arrived as stowaways. Scorpions are commonly found in cupboards, closets, in shoes, and under beds. 
      Being infected by scorpion venom results in a local reaction which while painful is easily treated with anal­gesics, antihistamines, ice, and sup­portive care. Nausea or vomiting is not uncommon.
      In more serious stings, pain and tingling may be followed by marked changes in blood pressure (high or low), high fever, or difficulty breath­ing. Symptoms that signify a more serious venom reaction include restlessness, rotary or roving eye movements, involuntary muscle spasms, difficulty swallowing, excessive salivation, or blurred vision. Shock or respiratory arrest may ensue without prompt medical intervention.
      Treatment
      Elevate the injured limb at or above the heart. An ice cube may limit pain to the wound. Analgesics such as Tylenol or ibuprofen may be taken for minor pain. Intravenous or intramuscular injections of meper­idine (Demerol) or morphine may be used if the pain is severe. Calcium gluconate (10 ml of 10% solution) may be given intravenously for muscle spasms. Valium may be given intravenously for anxiety and restlessness.
      As to antivenom, this is available in most Mexican hospitals for more serious stings. There is always the possibility of a severe allergic reaction to the antivenom; thus, it must be administered by a physician in a hospital setting.
      Snake Bites
      With over 320 species in Mexico alone, it is no wonder the snake is stamped on its flag and plays such an important role in the country’s history. Of the different types of snakes, only the rattlesnake (cascabel or crótalo), red coral snake (coralillo), nauyacas, and cantiles snakes are venomous.
      The rattlesnake, familiar because of its rattler and triangular head, accounts for 45% of snakebites. Masters of disguise, their colors and patterns allow them to blend well with their surroundings, often seeming invisible. The nauyaca snake accounts for 43% of snakebites, and varies significantly in color and size. The highly venomous red coral snake, recognized by its red-yellow-black or black-red-black rings, accounts for only 4% of snakebites.
      In Mexico, between 500-700 bites are reported annually. Mortality rates are low (less than 1%), as not all snakes are venomous or are unable to inject their venom, and because accurate treatment is administered in a timely manner. Since 72% of snakebites occur on the feet and ankles, it is  advisable when hiking in a high-risk region to wear thick-soled, high-top boots.
      Treatment
      If a snake bites you, keep calm and seek immediate medical attention. If the snake has administered its venom, you will require anti-snake bite serum. Until you receive medical attention, minimize your activity and immobilize the area bitten, keeping it below the heart. Do not apply ice to the bite area, do not make any incisions, do not apply a tourniquet, and do not administer alcohol or take drugs (especially Demerol, codeine or morphine). If you will be hiking in high-risk areas, be sure to purchase a snakebite kit and booklet.
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