Scorpion Sting: Symptoms, Treatment, and Prevention

Family – Buthidae. This family includes all neurotoxic scorpions, with 1500 species spread over 6 families. 

Mesobuthus tamulus is one of two significant species in India. Anendemic concern in rural India. Also called Indian red scorpion.

Palamnaeus gravimanus- Also called Indian black scorpion.

Clinical Features

Local

Iberiotoxin: Acts on calcium-activated potassium channels;  Action on voltage-gated sodium and potassium channels. Myocardial damage; Coronary vasospasm;  Smooth muscle contraction. Bradykinin and kallikrein can cause pancreatitis and non-cardiogenic pulmonary edema.

Scorpion venom acts on voltage-gated sodium and potassium channels to trigger an autonomic storm. Substance P is the source of acute local discomfort.

Signs of parasympathetic nervousness.  Sympathetic Manifestations: because of alpha receptor activity-  Hyperkalemia, Vasoconstriction, Insulin reduction (causing hyperglycemia and an increase in free fatty acids).

Also Read: Rapid Acquisition Of Key Concepts General Medicine

Investigations

• If WBC > 25000/cu.mm, leukocytosis is present (severe envenomation) in the CBC.
• Electrolytes: High potassium
• Increased troponin I/T and CKMP, two cardiac markers
• CXR: Pulmonary edema evidence
• ECG: tall "t" waves, ST-T alterations, ventricular and supraventricular arrhythmias, left atrial hemiblock, bundle branch block, and total heart block.
• The most typical is sinus tachycardia; 2D echo
• Lower interventricular septal motility; Reduced left ventricular ejection fraction;  Takotsubo cardiomyopathy (in rare cases).

Management

All bites from scorpions should be handled as malignant.  Needs to have a 24-hour observation period for symptoms. Treatment for localized symptoms.  ‘3’ side ring blocks of lidocaine. NSAIDs

Pentazocine and other opioids should not be taken with benzodiazepines.  Treatment for systemic symptoms

Fluids: Increased use could result in pulmonary edema. The internal jugular vein line or IVC collapsibility monitoring system should be utilized to administer fluids in the appropriate volumes. 

Prazosin: Death Rate < 1%. It inhibits phosphodiesterase and the alpha 1 receptor. By inhibiting the Alpha 1 receptor, the hypertensive crisis is decreased.  Diminishes pulmonary edema.  Using Phosphodiesterase Blockers.

Boosts the synthesis of insulin; this enhances glycemic control.
Decreases Free Fatty Acid Circulation.  Gates potassium channels that are calcium gated. Because it induces vasodilation and decreases coronary vasospasm, prazosin is the ideal treatment for scorpion poisoning.

Anti-Scorpion Venom

In stock in India -  Pricey
Evidence of systemic envenomation is the indication, and a test dosage is not necessary. Due to the little chance of anaphylacti- If administered early in the parasympathetic phase, it will be most effective.

Made prazosin useful for treating scorpion bites; Prazosin is being utilized as an antivenom for scorpion stings worldwide.

Hope you found this blog helpful for your NEET SS General Medicine preparation. For more informative and interesting posts like these, keep reading PrepLadder’s blogs.