Scorpion Sting Care for Small Children

It has taken me a few days since our experience to be able to process everything that happened. I did not particularly want to write about it or relive it in order to write about it- but I honestly have learned so much invaluable information that I feel I HAVE to share it with other parents. 

On Monday night  my 9 month old was stung, in the mouth, by a Bark Scorpion. 

It sounds bizarre and weird- but it happened and it was absolutely terrifying. In a lot of ways we were very lucky with the way the events unfolded. Let me explain. 

It was a regular Monday night. We had just finished dinner ( I tried a new white chicken chili recipe that was delicious) and my husband grabbed the kids after we finished eating to get them in the tub. I was relaxing for a couple of minutes before cleaning up dinner when I heard my 9 month old (almost 10 months) scream a very weird high pitched cry from the tub. He kept screaming and I heard my husband asking, "Whats wrong buddy? What happened?" Then I heard my husband scream "OH MY GOD! AUBREY HURRY OH MY GOD AUBREY GET IN HERE" before I could sprint to the bathroom my husband was in the hallway handing me a naked screaming baby and my toddler was standing naked in the bathroom. Matt said, "He was stung by a scorpion. Call your parents. We are going to the hospital". I ran to the living room and started to check his body for a sting and couldn't find a mark,  For a split second I thought, "I don't see anything- he is probably fine" but then my son started screaming again and I could tell he was in a lot of pain. Within 5 minutes- I had him dressed, my parents had got to our house, I instructed my husband to catch the scorpion (which had drowned) and put it in a cup to bring with us. Which sounds like an odd request but, about a year ago I had read a random blog post about a woman whose daughter was bit by a snake of some sort- or maybe it was a spider... I don't remember the specifics but I remembered that she had brought said venomous creature to the hospital and it had saved her daughters life somehow. So in the chaos that memory flashed into my head and we ended up in our minivan, speeding towards the hospital, with a screaming infant, two shocked parents and a dead scorpion in a sippy cup. 

Once we were in the car and it had been about 10 minutes or less since the sting the symptoms started to arise in my son very intensely. I want this post to be as informative as possible- so I am going to use some medical terms. Almost immediately after the bite- the only symptom was his screaming in pain. With a baby- there was no way he could tell us where it hurt or what anything felt like- he was only screaming. In the van he began to shake uncontrollably and large amount of drool began to come out of his mouth. I thought this was from crying. He became very red from the screaming, but the shaking was the symptom that had me worried the most. 

When we arrived we went straight to front and right to people for check in. We were borderline hysterical- but kept it together enough to inform them that he was stung by a scorpion, that his behavior was not normal and that we needed to be seen immediately. If you know my family- you know my son is a very happy, mild mannered baby. He rarely cries. He always has a smile on chubby little face and he is overall a calm little guy. By the time we made it to the hospital he was shaking uncontrollably, with his little hands balled in fists, crying and the drool was getting worse. The intake nurse was trying to calm us and was taking our information. They took him back to weigh him and had me hold him while they took his temperature rectally. All the time he was getting more red and he was shaking more and more. The intake person at one point said, "He just seems angry, are you sure he was stung?" That is when the sippy cup with the scorpion came in handy. I, as calmly as possible, told her- "My baby does not get angry. He does not shake like this. He never cries. I KNOW he was stung and here is the scorpion". Things moved a little faster after that. Within minutes we were brought back to a room and at that point he was laying on the table, convulsing, foaming drool from his mouth, with his eyes rolled back in his head. This was maybe the worst moment of my entire life. My husband and I were completely panicked and felt helpless. We literally stood in the hallway asking for a doctor over and over, crying, and basically freaking out until a doctor came a couple of minutes later (which felt like hours, but in retrospect was very fast). After some research I have learned there are 4 Grades of Envenomation which are as follows: 

SOURCE: http://www.anascorp-us.com/resources/Expanded_Brochure.pdf

SOURCE: http://www.anascorp-us.com/resources/Expanded_Brochure.pdf

Opsoclonus refers to uncontrolled eye movement. Opsoclonus consists of rapid, involuntary, multivectorial (horizontal and vertical), unpredictable, conjugate fast eye movements without intersaccadic intervals. (source: google) 

Our sweet baby boy was at a Grade 4 envenomation. I have to say watching his little body shaking and jerking uncontrollably, while his eyes were darting back and forth until they just rolled to the back of his head and him foaming and drooling from his mouth was the worst moment of my entire life. Once the doctor came in he looked at the scorpion, tried to calm us down and immediately got a team of people in the room. With about 6 nurses in there they were able to hold him down to attempt to get an IV. He is a strong little guy- and he was thrashing so uncontrollably it took about 20 minutes, and many failed attempts to get an IV in place. One nurse was suctioning out the drool so he wouldn't choke and giving him albuterol mist to keep his airways open along with oxygen, the other 4 or 5 nurses were trying their hardest to hold him down. We are so blessed that a pediatric nurse was walking by at the time and she immediately came in when she saw what was happening and took control. She had them turn out the lights and used a light to find a vein, I was trying my best to help and was whispering in his ear whenever he thrashed in my direction. After 3-5 failed attempts (this part is blurry but I know both arms and both hands were tried) they finally asked me to hold his arm down and for some reason that IV worked- thank God. So they could administer the anti venom- Anascorp. Let's take a minute and talk about anti venom. 

Here in Las Vegas not all hospitals carry anti venom. I was under the false thought that the hospital we went to did not carry anti venom because they called to the pharmacy to get some. I was mistaken and didn't realize they must have just called to the hospital pharmacy because the anti venom got to us FAST- within 5-10 minutes and was waiting when they finally got the IV. Here is a list of the hospitals in Las Vegas that carry anti venom and link to a resource for Arizona, Nevada and Utah hospitals that carry it. 

LAS VEGAS: 

CENTENNIAL HILLS HOSPITAL
6900 N. DURANGO DR
LAS VEGAS, NV 89149

MOUNTAINVIEW HOSPITAL
3100 N TENAYA WAY
LAS VEGAS, NV 89128

SOUTHERN HILLS HOSPITAL & MEDICAL CENTER
9300 W SUNSET ROAD
LAS VEGAS, NV 89148

SUMMERLIN HOSPITAL
657 TOWN CENTER DR
LAS VEGAS, NV 89144

SUNRISE HOSPITAL & MEDICAL CENTER
3186 S MARYLAND PKWAY
LAS VEGAS, NV 89109

ST ROSE DOMINICAN HOSPITAL  – SAN MARTIN CAMPUS
8280 WEST WARM SPRINGS RD
LAS VEGAS, NV89113

UMC OF SOUTHERN NEVADA
1800 W. CHARLESTON BLVD.
LAS VEGAS, NV 89102

VALLEY HOSPITAL MEDICAL CENTER
620 SHADOW LANE
LAS VEGAS, NV 89106

HENDERSON

ST. ROSE DOMINICAN HOSPITALS – ROSE DE LIMA CAMPUS
102 EAST LAKE MEAD PARKWAY
HENDERSON, NV 89015

ST ROSE DOMINICAN HOSPITAL  –  SIENA CAMPUS
3001 ST ROSE PARKWAY
HENDERSON, NV 89052

LINK: http://www.anascorp-us.com/hospital/

Once the anti venom was administered it took about 1 hour for it to kick in. After the drooling stopped, and the thrashing- we were allowed to pick him up and carry him while he cried until it finally took away the pain. He still had not opened his eyes and when he did for a few seconds he could not focus due to the sedative he was put on and after effects of the venom which were still lingering. The treatment plan was to administer the first dose of Anascorp- wait one hour- reassess the situation and decide if needed another vial. The FDA recommends 3 doses (vials) within 30 minutes of each other then assessment. But with our sons age- and the increased risk of side effects with more Anascorp- our doctor wanted to see if one vial would do the job- and it did. We really loved the doctor we got by the way- he had young kids, so we knew he could sympathize- and did everything right in our opinions. 

Later that night after he kept down some food we were able to take our sweet baby home (well to my parents house because no way in hell we were going home to the scorpion palace that night). Not 6 hours after this ordeal our son was crawling on the living room floor. We went from being absolutely scared to death at the thought of losing our son- to watching him crawl around. It was the most surreal experience- going from one end of the spectrum with our emotions to the the other extreme within that short of a period of time. 

Now lets talk scorpions. The scorpion the stung our son was a Bark scorpion. What is a Bark scorpion you may ask- well let me tell you. 

"The U.S. is home to at least 40 species of scorpions. Stings can cause local pain and swelling and do not usually warrant medical treatment. In fact, most stings can be managed at home with basic first aid. However, one species in the U.S. is regarded as medically significant:

Centruroides sculpturatus, better known as the “bark scorpion.” Most commonly found in Arizona, isolated colonies have also been reported in Clark County, Nevada, parts of Texas, Western New Mexico, and California.

Symptoms of Bark Scorpion Envenomation

Patients stung by the bark scorpion experience an immediate burning and stinging sensation at the sting site. Following the pain, a pattern of neurotoxicity may develop with a spectrum of severity ranging from trivial to life-threatening. Severe envenomation, more common in small children, may involve loss of muscle control, roving or abnormal eye movements, slurred speech, respiratory distress, excessive salivation, frothing at the mouth, airway obstruction, and vomiting.

These symptoms are not due to an allergic reaction (as is sometimes believed), but instead to a neurotoxin contained in the venom. Specific ion-channel toxins stimulate or potentiate action potentials throughout the peripheral nervous system allowing the neurotransmitters to send and receive signals faster and faster resulting in these characteristic symptoms."

Bark scorpion stings were once responsible for the most venom-related fatalities in Arizona.  Improved access to health care facilities and advances in supportive care have contributed to a significant reduction in mortality.

Bark Scorpion Habitat

The bark scorpion is named because of its association with trees, and is commonly found in established residential areas. Our homes act as a desert oasis providing food, water and shelter. Since bark scorpions become active at about 72°F, it is no surprise that most people are stung by scorpions inside or around their own homes. Undisturbed scorpions will spend the daylight hours in cool, dark environments like in crevices, under tree bark, in woodpiles or under debris.

Most stings occur at night when scorpions venture into human habitat. Small cracks and breeches in homes, especially around doors and windows provide easy entry for small scorpions. With flat and elongated bodies, bark scorpions are the only scorpion that can climb vertical surfaces in our homes, and across ceilings. While practicing what is called “negative geotaxis”, or hanging upside-down, scorpions can drop from the ceiling and land in some unsuspected locations, like a fruit bowl or in an infant’s crib.

Bark scorpions only grow to about two inches at maturity. They have four pair of legs and a pair of pedipalps, or front limbs with pincers, that are used for restraining prey, as well as for defense. Scorpions inject venom from a stinger on their tail and not by biting their victims, as is sometimes mistaken.

In the last 400-million years, the scorpion’s design has changed very little proving that it is an efficient design. Attempts to exterminate are futile, although chasing away their food source (e.g. crickets)
to another part of the yard may be effective. The co-habitation of humans and bark scorpions requires us to be prepared at all times and is an integral
part of living in the Southwestern United States. "

source: http://www.anascorp-us.com/resources/Expanded_Brochure.pdf

 I have also learned that they usually are in groups of 20-35 scorpions and that a mother will give birth to 20-35 babies. Baby scorpions are even more deadly- because they cannot control the amount of venom they give in a sting and usually give all of their venom. People think we are crazy- but after watching our son in a life threatening situation and in immeasurable amounts of pain we are moving from our house. Yes- there are scorpions all over Las Vegas- but once they are IN the house it is very hard to get rid of them. This is probably the 7th or 8th scorpion we have found inside our home- and the rate of finding them was increasing. If we had older children we wouldn't worry and wouldn't think about moving. But we have a baby, and want more babies eventually, so staying in an environment we know is unsafe is not an option for us. My husband and I will remember this traumatic event in great detail for the rest of our lives and will do everything in our power not relive it. 

SO what DO YOU do if you suspect your infant or baby was bit by a Bark scorpion? Here is a list I made- we did almost everything right but there are some things we could have done differently. 

I know this list seems silly- but acting as quickly as you can is THE MOST IMPORTANT thing. The venom started causing the symptoms with our son FAST. Probably because he was stung on the inside of his lip (it was in a bath toy he was playing with) and the venom went directly to his brain. The faster you get the anti venom the faster your baby will be out of pain. Hopefully- if your small child is stung- or if you are stung- you will only experience pain and not severe symptoms. Most adults do not need to go to the hospital- our bodies are largerr so the venom is not as concentrated, and we can metabolize the venom pretty efficiently. 

If you live in a home where you have scorpions make sure to check beds and cribs before laying infants in them, look through your home at night with a black light to find them and apparently- shake out your bath toys before pouring them into the bath. Also shake out shoes before putting them on and try not leave piles laying around the house. We have a monthly bug spray from our bug guy- but killing off the food source was not enough in our case. Also- if you live in Vegas and are reading this and are now freaked out- please don't be! We knew we had a problem with scorpions. We did not know they were bark scorpions- but we had found them in our house a bunch of times and did what we thought was enough to keep the problem at bay. Growing up in Vegas this was always a way of life. If you have lived in your home for a while and have never seen a scorpion inside you don't need to lose any sleep over this. If it is a problem- you will know because you will find them inside your house. I wish we would have paid more attention to the type that was in our house but we honestly just killed them when we found them and I did my best of keeping food off the floor and bugs out of our house. It is rare for this to happen- but now that it has I hope our story and some of this information can equip  parents out there in case this crazy ordeal happens to you. In the meantime- hug your babies tight and equal yourself with this information- just in case. 

God Bless!