Scorpion Bite, Scorpion Sting Symptoms, First Aid, Treatment

Scorpion stings are painful but rarely life-threatening. Young children and older adults are most at risk of serious complications of scorpion Bite.

In this article, you will get Everything about Scorpion Bite, Scorpion Sting Symptoms, First Aid, Treatment of scorpion bite, what to do if a scorpion bites you? scorpion bite treatment injection, how long does a scorpion sting last, scorpion bite India.

Objectives:-

• At the of the session, participants will be able to learn.
• Clinical Features of scorpion sting.
• Learn the grading according to the severity of bites.
• Treatment and early diagnosis.

Introduction:-

• Scorpion envenomation is an occupational hazard for farmers, farm laborers, migrating
• population and hunters – The endemic areas are western Maharashtra, Karnataka and Konkan Region.
• Severe Scorpion stings are due to MesobuthusTamulus species of scorpion

Clinical features of Scorpion bite:-

Clinical features of Scorpion Bite, Scorpion Bite Symptoms, Scorpion Sting Symptoms:-

1. he venoms of genera Hadrurus, Vejovis, and Uroctonus have local effects only including sharp burning, swelling, and discoloration at the bite site.
2. The second type of venom produced by the genera of the poisonous varieties of Centruroides and Mesobuthus contains neurotoxins that block sodium channels.
3. This leads to spontaneous depolarization of parasympathetic and sympathetic nerves which results in stimulation.
4. In adults, the first time is rarely dangerous. But if the second time, the person may die if not treated soon. The body becomes allergic after the first sting. So it is important to find out if he had an earlier scorpion sting.
5. Severe pain, redness, and swelling at the site of the sting
6. Clinically ―autonomic storm‖ evoked due to venomous envenoming is characterized by transient parasympathetic – vomiting, profuse sweating, ropy salivation bradycardia, ventricular premature contraction, priapism in male, hypotension and
7. Prolonged sympathetic – cold extremities, hypertension, tachycardia, pulmonary edema, and shock.

On the basis of clinical manifestations at the time of arrival to hospital and according to severity they are graded in 4 grades.

Grade 1:

Severe excruciating local pain at the sting site radiating along with
corresponding dermatomes, mild local oedema with sweating at the sting site, without systemic involvement.

Grade 2:

Signs and symptoms of autonomic storm characterized by acetyl choline
excess or parasympathetic stimulation and sympathetic stimulation

Grade 3:

Cold extremities, tachycardia, and hypotension or hypertension with pulmonary edema (Respiratory rate > 24 per minute, basal rales or crackles in the lungs).

Grade 4:

Tachycardia, hypotension with or without pulmonary edema with warm
extremities (warm shock).

Scorpion Bite Investigations-

1. ECG- Tall T waves are a common finding. Others are atrial arrhythmias, nonsustained ventricular tachycardia and various conduction defects are seen
   
2. Chest Xray- shows pulmonary edema.

Treatment of Scorpion Bite:-

Management of Scorpion bite, Treatment of Scorpion Sting:-

If it is for the first time in adult, do the following

• Give paracetamol if possible, put ice on the sting
• Infiltration of the site with a local anesthetic may relieve pain and anxiety.
• Antihistaminic tablets can be given

If the sting is for the second time in adult or is in children under 5, do the following:-

Scorpion sting / Scorpion Bite management Treatment protocol in India:-

1. IV Fluid management
2. Inj scorpion antivenom 30ml in 200ml of normal saline neutralizes circulating venom.
3. If evidence of myocarditis and pulmonary edema, strict bed rest, and management of heart failure is indicated.
4. Prazosin:- Prazosin 0.5mg 3hrly orally for the first 2 days (or 0.25 mg in children and for adults) is an acceptable therapy.
5. Injection frusemide:- Injection frusemide 20 to 60 mg iv to control pulmonary edema.
6. Inj Dobutamine 5-20 microgram/kg/min iv given in heart failure, tachycardia, pulmonary edema with warm extremities
7. Patients in pulmonary edema may need inj NTG drip 5 microgram per kg

At times with severe respiratory distresss may need non invasive ventilation or mechanical ventilation.

SCORPION STING: STAGES, CLINICAL PRESENTATION, AND TREATMENT:-

Stage 1 (0-4hrs)	Stage 2 (4-6hrs)	Stage-3 (6-10hrs)		Stage-4 (10- 12hrs)	Stage-5 (>12hrs
Sweating, Salivation, Mydriasis, Priapism, Hypotension, Cold extremities	Hypertension, Tachycardia, Cold extremities	Tachycardia, Hypotension, Pulmonary edema, Cold extremities		Massive pulmonary edema	Warm extremities, Tachycardia, Hypotension, Pulmonary edema, Gray pallor (warm shock)
ASV + Prazosin	ASV + Prazosin	ASV +Prazosin +Dobutamine		AVS +SNP or NTG + NIV/MV	Dobutamine

ASV – Anti Scorpion Venom, SNP- Sodium Nitro Prusside, NTG- Nitroglycerine, NIV-Noninvasive ventilation, MV – Mechanical Ventilation

Exercise:-

1. According to severity scorpion sting is graded in Grades.
   (One/Two/Three/Four)
2. Describe the treatment of Scorpion Sting according to stages.