Should All Scorpion Stings be Followed Up in the Intensive Care Unit?

Ayse Sahin Tutak,Bulent Karakaya,Oznur Uluadag,Huseyin Avni Findiki,Meral Celiker,Atilla Tutak

doi:10.26502/acbr.50170035

Abstract

Aim: In Turkey, as throughout the world, the incidence of scorpion sting cases and the wide-ranging clinical table, extending from local symptoms to death have not been previously estimated. Therefore, through an examination of patients followed up in the Intensive Care Unit (ICU) and the complications, the aim of this study was to evaluate the indications for acceptance of these cases into ICU. Method: A retrospective examination was made of 59 patients admitted to the ICU of Adiyaman Training and Research Hospital because of a scorpion sting between 2013 and 2016. Results: All the patients had a unilateral extremity sting, presented at the Emergency Department within 8 hours and were administered anti-venom. In respect of local or systemic complications, thrombus developed in the proximal of the extremity in only 2 patients. With the exception of these 2 patients, all the other cases were discharged within 2 days without complications. Conclusion: Although the most poisonous scorpion in the world can be found in our region, no case admitted to the ICU in this 3-year period experienced any systemic complications. This is thought to be due to the early presentation at ED within the first 8 hours and that antivenom is produced in our region. In conclusion from this study, it can be recommended that patients with no requirement for the equipment of ICU should not be admitted and patients with local symptoms only should be monitored on the ward.

Highlights

Scorpions generally inhabit tropical and subtropical climates, living in particular in forested regions, deserts, and stony, rocky regions
When cases of scorpion sting present at the Emergency Dept, the symptoms are carefully evaluated, the necessary supportive treatments are given, and in the monitoring of symptoms, follow-up can be monitoring in the ED and when necessary transfer can be made to Intensive Care Unit (ICU)
No statistically significant difference was determined between the patients accepted into ICU in this study in respect of age and gender (Table 1)

Summary

Introduction

Scorpions generally inhabit tropical and subtropical climates, living in particular in forested regions, deserts, and stony, rocky regions. More than 1500 scorpion species have been identified throughout the world, only about 30 of these are poisonous. Cases of scorpion poisoning in Turkey are seen most often in the South-east Anatolian region [1]. The most poisonous scorpion in the world, the Leiurus quinquestriatus has been determined in the province of Adiyaman and surrounding areas in South-east Anatolia [2]. The poisonous Mesobuthus nigrocinctus (black spotted yellow scorpion) was identified for the first time in the world in Adiyaman and inhabits the area surrounding Mount Nemrut (Ehrenberg 1828, Crucitti & Vignoli 2002). When cases of scorpion sting present at the Emergency Dept, the symptoms are carefully evaluated, the necessary supportive treatments are given, and in the monitoring of symptoms, follow-up can be monitoring in the ED and when necessary transfer can be made to ICU. The aim of this study was to evaluate patients followed up in ICU for a scorpion bite in respect of the indications for admittance to ICU and complications which developed

Objectives

Methods

Results

Discussion

Conclusion