Systemic manifestations of scorpion poisoning occur in less than a third of victims of scorpion bites. These manifestations result from the release of neurotransmitters in response to the effect of the toxin on sodium channels. These neurotransmitters elicit a strong and complex response in the form of adrenergic or cholinergic syndrome, which is associated with an inflammatory response, particularly in tityus and paleotropic scorpion poisoning (see full reviews by Freire-Maia et al. and Ismail).16–18 Symptoms develop rapidly, within a few hours, leading to a number of clinical pictures depending on the type of scorpion. They are associated with biological disorders, the most common of which are leukocytosis, hyperglycemia and lactic acidosis. There is a significant increase in biomarkers of muscle necrosis, particularly cardiac (aspartate transaminase, creatine phosphokinase and troponin I), hepatic (alanine transaminase, gamma-glutamyltransferase, alkaline phosphatase) and pancreas (lipases, amylases), the latter being likely to occur more frequently after poisoning by South American Tityus. Electrolytes are disturbed (hyponatremia, hypocalcemia, hyperkalemia), especially with severe intoxication, which announces a poor prognosis. Arterial oxygen saturation (SaO2) is probably less than 90%. Make sure windows and doors are airtight to prevent scorpions from entering the house. The aim of this review is to update knowledge on the management of scorpion bites and the treatment of scorpion poisoning, to discuss the benefits and limitations of early immunotherapy compared to medical resuscitation, and to propose a standardised management plan based on a combination of the two strategies. This treatment protocol will enable the therapeutic use of Anascorp in the treatment of systemic manifestations of scorpion site poisoning in patients for whom antivenom would not otherwise be available.
The working hypotheses are as follows: In a prospective, randomized, double-blind study, Boyer et al. compared scorpion-specific antivenom F(ab`)2 (Anascorp, Intravenous [horse] immune F(ab)2 immune centrium [scorpion]2), Instituto Bioclone) (n = 8) with placebo (n = 7) in children who developed neurotoxic symptoms after scorpion poisoning. [36] Neuromotor abnormalities were present in all patients at baseline, and shortness of breath was present in 20%. From 2 hours after treatment, resolution of symptoms in the antivenom group differed significantly compared to the placebo group. Plasma venom concentrations were undetectable and neurological syndrome ended neurological syndrome within 4 hours in 100% of antivenom recipients compared to 1 placebo recipient (p=0.001). The usefulness of vacuum extraction equipment for scorpion stings has not been evaluated. Scorpions are a very homogeneous group of arthropods that includes about 1500 species, of which about 30, all belonging to the Buthidae family, are potentially dangerous to humans. They are shy creatures that are active at night in the warm season, but often live in homes or near populated areas, which explains the high incidence of scorpion bites in children in many parts of the world.
Grade II – pain and/or paresthesia away from the site of the bite, in addition to local signs Regardless of the treatment, i.e. antivenom or intensive care, mortality has been shown to decrease wherever treatment of scorpion bites has been anticipated and organized by health authorities.1 However, The choice between the two options requires a realistic consideration of all relevant parameters, including logistics. In addition, mortality should not be the only endpoint; It is also necessary to take into account the simplicity of management and the speed of recovery. The complexity of conflicting clinical symptoms leads to difficulties in the choice of symptomatic treatments, especially since the progression of symptoms and the appearance of complications can be rapid. While some drugs can be used systematically with a relevant and precise protocol, many others remain the prerogative of the specialist. In contrast, antidote treatment, designed to quickly remove poison from the body, is probably the most logical and now the easiest to handle with low risk. Purified IgG fragments are very effective and safe, even when administered by non-medical personnel, provided they have been trained. Administered early, they can prevent serious complications and reduce referrals to referral hospitals, but this strategy requires easy access to antidotes in remote health care settings. Many medications that target cardiac treatment have been suggested to treat high blood pressure, arrhythmia, heart failure, and pulmonary edema associated with scorpion poisoning. However, it should be borne in mind that the main reason for these symptoms is the increase in vascular resistance caused by peripheral vasoconstriction resulting from the action of catecholamines. The first symptom of scorpion poisoning is localized pain, which reflects the penetration of the poison and is a valuable warning signal, especially in children. Pain is present in more than 95% of cases of intoxication and may be associated with edema and erythema (in 20% of cases), less often small blisters.
If you are unsure of the type of scorpion that stung you or if you develop symptoms of an allergic reaction, seek immediate medical attention. These symptoms may include difficulty breathing, extreme swelling, vomiting, and shock. If necessary, use an epinephrine auto-injector (EpiPen®) and call 911 or go to the nearest emergency room. Treatment of scorpion bites depends on the type of scorpion involved and the amount of poison injected. Most people don`t need to see a health care provider for a scorpion sting. However, you can call the poison control center for advice. What you can do to treat scorpion bites at home includes: The treatment protocol, which includes up to 25 sites in Arizona, increases the total number of subjects receiving Anascorp™ and can provide additional safety data for the examination process. At the same time, it will prevent a public health crisis in rural Arizona by replacing the supply of local antivenom seduction before a BLA is approved. State surveillance of the public health problem of the scorpion is justified. Scorpion stings are common emergencies in many parts of the world.1 The estimated annual global incidence, based on national health data, is about 1.5 million poisonings with 2600 deaths (Figure 1).
Although the incidence of scorpion bites is higher in adults, the severity of poisoning is significantly higher in children, where the case fatality rate is up to ten times higher than in adults.1–6 However, the incidence of scorpion bites is poorly understood, although mortality appears to have decreased in most countries with appropriate treatment.1, 2,5 Victims of scorpion bites get to the hospital more easily and quickly. where appropriate care can be provided. This is a consequence of increased consideration of poisoning by health authorities.2,5 The epidemiology of poisoning, including the frequency and circumstances of scorpion bites, has led to better allocation of resources, adequate training of health workers, and implementation of accident management strategies.7 Neuromuscular diseases are most often treated with drugs that activate acid receptors. gammabutyric (GABA), which activate the Inhibit the excitability of postsynaptic neurons. Benzodiazepines have the advantage over other anticonvulsants, such as barbiturates (e.g. phenobarbiton) due to their rapid distribution in the body and short half-life. Barbiturates also have a depressive effect on breathing. Midazolam is most commonly used, particularly in North America.45,46 Elsewhere, particularly in Africa and the Middle East, diazepam is widely used.39 In addition, benzodiazepines are beneficial in the treatment of high blood pressure and may be the first drug of choice in the treatment of scorpion poisoning.
Hospital care depends on the severity of the poisoning and consists of stabilizing the patient, neutralizing the poison, offering supportive therapies and preventing complications. Patients with grade III or IV centroxidal points and other serious buthid poisoning should be admitted to the intensive care unit and/or treated with antivenom. Biological control methods for scorpions include introducing chickens, ducks and owls to the area. Very often, studies suggest cardiovascular complications against respiratory failure, when both could be the result of a) a difference in the composition of the poison, b) delayed consultation, or even c) inappropriate initial treatment. In case of medical delay due to remoteness, you should apply a 1-inch proximal lymphatic-venous compression sheath to the puncture site to reduce the superficial venous and lymphatic flow of the poison, but not to stop arterial flow. Remove this envelope only if the provider is willing to manage systemic support.