Treatment is similar to that for spider bites, although scorpion stings are generally less serious. Therapy of scorpion stings includes local wound care, topical ice, specific antivenin, and systemic support, including ventilation, control of tachyarrhythmias, and sedation. Children are particularly susceptible to the severe cardiorespiratory and neuromuscular dysfunction associated with envenomation. Local signs of envenomation are minimal, whereas systemic neuromuscular findings are present in the sympathetic and parasympathetic systems. Bark scorpions are the only toxic species in the United States however, others are common in Mexico and equatorial countries. Scorpion stings in children have serious sequelae. Envenomations by black widow spiders are managed by local care, fluid and cardiovascular support, parenteral calcium gluconate, muscle relaxation, and antivenin. 53–55 Local signs of a bite can be limited and are followed by systemic neuromuscular symptoms of diffuse rigidity and spasm that potentially lead to respiratory arrest approximately 1 hour later. 50–52īlack widow spiders are venomous New World spiders the females are black with an hourglass-shaped red mark on the abdomen. Radiographs should be obtained to exclude retained teeth. These injuries are managed by removing the animal from its victim, followed by local and systemic supportive care. Wounds show edema, but tissue loss is less pronounced than that associated with envenomation by pit vipers however, systemic signs can ultimately be similar. These lizards inject venom as long as they cling to the victim. Gila monsters, which are found in the southwestern United States, and their relative the Mexican beaded lizard are active in late spring. Bentz, in Pediatric Surgery (Seventh Edition), 2012 Other bite injuries