04 November, 2010

Scorpion stings in Children - Treatment

Rajniti Prasad and co-workers have recently published a study on scorpion envenomation in children in India and the factors affecting the outcome. It is well known that children are at greater risk of developing severe cardiac, respiratory and neurological complications as compared to adults.

The current study present a management protocol for scorpion sting enevomation.

The most dangerous scorpion in India is Hottentotta tamulus (previously known as Mesobuthus tamulus) in the family Buthidae.

Objective To identify and correlate various factors affecting the outcome of children with scorpion sting envenomation treated with prazosin in a tertiary care hospital. Methods The study included 90 children admitted with scorpion sting envenomation over a period of four and half year. Grading of severity was done on the basis of local or systemic involvement, and management protocol was followed as per hospital guidelines. All cases with envenomation were given prazosin at a dose of 30 μg/kg/ dose;first repeat dose at 3 h followed by every 6 h till recovery. Patients with acute pulmonary edema (APE) were treated as per standard protocol. Results All patients had perspiration and cold extremities. Most of them had sting over extremities except two,having over the trunk. Shock was present in 48(53.3%), whereas myocarditis, encephalopathy, pulmonary edema and priapism were present in 38(42.2%), 32(35.5%), 34(37.8%), and
28(31.1%) children, respectively. Eight (8.9%) children had died. The mean value of blood pressure, sodium and potassium among survivors and non-survivors was insignificant. Mortality was significantly higher in children presented after 6 h of bite. Patients, who had metaboloic acidosis, tachpnea, myocarditis, APE, encephalopathy and priapism had significantly higher mortality (p<0.05).

Prasad R, Mishra OP, Pandey N, Singh TB. Scorpion Sting Envenomation in Children: Factors Affecting the Outcome. Indian J Pediatr. 2010 Oct 13 [ePub ahead of print]. [Subscription required for fulltext]

No comments: