Abstract
Scorpion sting envenomation is very common problem in rural India especially where the climate is hot and dry. Management techniques have improved tremendously over the time leading to reduced morbidity and mortality. Mortality is mainly when ignorant patients go to the traditional faith healers (Tantrics) and come late to the facility where better management is available. Indian red scorpion (Mesobhuthustamulus) is the main species in India. Autonomic storm caused by venom acting on sodium gated and other channels is the main cause of manifestations in a scorpion sting victim. Cardio-myopathy is the main cause for morbidity and mortality. Many grading systems have been suggested for categorizing and simplifying the treatment. The mainstay of treatment where systemic involvement is there are alpha-1 blocker Prazosin hydrochloride, Fluids and newly arrived purified anti-venom. Scorpion envenomation being a problem of rural remote areas and most patients being from lower socio-economic status, anti-venom use is limited. Hence the treatment of choice remains Prazosin hydrochloride. Risk factors, peculiarities of presentation and dose titration of Prazosin based on severity will be discussed as per personal experience and literature review.J Nepal Paediatr Soc 2016;36(3):284-287
Highlights
There are around 1500 species of scorpion in the world and only 30 are poisonous
Different species are found in different geographical area and have different manifestations[1]
Most affected countries in world are from Africa especially Tunisia and most affected country in Asia is India
Summary
There are around 1500 species of scorpion in the world and only 30 are poisonous. Venomatous scorpions are mainly from Buthidae family. As different manifestation are observed in different geographical areas due to variation of scorpion species and their venoms,the management differs. Many times when systemic symptoms are severe, local pain may not be felt by patient and pain appears when symptoms resolve. This is a useful sign of recovery[4]. Parasympathetic activity like profuse sweating, vomiting, salivation restlessness and hypotension are first to appear This lasts for 30-40 minutes and is followed by sympathetic activity like tr emors,anxiety,tachycardia,tachypnea, hypertension and cold extremities due to vaso-constriction.This stage lasts for 6-12 hrs[8,9].Patients are usually brought in this phase as first phase goes in travelling or with the tantriks.
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