European Journal of Cardiovascular Medicine

Background: Scorpion envenomation is a potentially fatal public health risk in tropical and subtropical places around the world. [1] However, morbidity and mortality from venomous animal bites or stings have received little attention in poor nations, including India. This is evident in the absence of a system for reporting venomous bites or stings. Objectives: 1. To study the clinical presentation, course, complications and outcome of scorpion sting envenomation. 2. To study the epidemiology and circumstances leading to scorpion sting in the community. Material & Methods: Study Design:  Hospital based prospective cross-sectional study. Study area: The study was conducted in the Department of Paediatrics. Study Period: 1 year. Study population: All the children admitted for scorpion sting into hospital.  Sample size: Study consisted a total of 54 subjects. Sampling Technique:  Simple Random technique.Study tools and Data collection procedure: On admission, a detailed clinical history, including the time of sting, symptomatology, details of treatment received before admission was taken. Further a description of the scorpion and details about the circumstances leading up to the sting were obtained. All the patients were subjected to a detailed clinical examination at admission and at frequent intervals thereafter, as was necessary in each case. Hourly monitoring of heart rate, respiratory rate, blood pressure, urine output, cardiovascular and respiratory status was done. Results: Commonest complications were, peripheral circulatory failure, pulmonary edema, Myocarditis and Congestive cardiac failure (15% of cases). One child developed popliteal artery thrombosis 76 hours after admission to hospital. Three patients presented with Encephalopathy, two of whom had massive pulmonary edema and succumbed within 5 hour of admission. One child had left sided hemiparesis and encephalopathy, secondary to Left MCA territory infarct with mild pulmonary edema. Conclusion: In India, cardiovascular complications are most common and life threatening. However, anticipation and close monitoring for other uncommon complications is critical for effective management. Prazosin has revolutionized the management of scorpion sting envenomation. Administration of prazosin, as early as possible, is probably the single most effective intervention for preventing complications following scorpion sting.