Scorpion sting: a narrative review and proposed guidelines for contemporary UK armed forces operations

Scorpions are venomous arthropods with a wide geographical footprint and are endemic throughout all UK Armed Forces operational areas outside of Northern Europe. Scorpion stings are common on military exercises and operations. Here, we present a narrative review summarising epidemiological data pertaining to scorpions in geographical areas of contemporary operational relevance to the UK Armed Forces and suggest evidence-based treatment recommendations suitable for use in a military environment, providing an update to the last detailed review in 2008. The overwhelming majority of stings will result only in local pain and can be managed with analgesia at Role 1 medical treatment facilities. The risk of severe envenoming is greatest in the Middle East. Children and pregnant women are at increased risk of severe envenoming which most commonly manifests as hypertensive crisis. These patients should be evacuated to hospital care and managed supportively in a critical care environment.