Overview
What is the global incidence of scorpion envenomation?
What are the manifestations of scorpion envenomation?
How are venomous scorpions differentiated from nonvenomous scorpions?
Which scorpions are lethal and where are they commonly found?
Where do scorpion stings commonly occur?
How do scorpions inject venom in their prey?
What is the pathophysiology of scorpion envenomation?
What are the pathophysiologic targets of scorpion venom?
What is the pathophysiology of neurotoxin in scorpion venom?
What causes scorpion envenomation?
What is a lethal dose of scorpion venom?
How much scorpion venom is released on average per sting?
What is the incidence of scorpion envenomation in the US?
What is the global incidence of scorpion envenomation?
What are the racial predilections of scorpion envenomation?
How does gender affect susceptibility to scorpion envenomation?
How does the susceptibility to scorpion envenomation vary by age?
What is the mortality rate for scorpion envenomation?
How does age and location affect mortality rates for scorpion envenomation?
What is the prognosis of scorpion envenomation?
What information about scorpion envenomation should patients receive?
Presentation
What is the focus of clinical history in patients with scorpion envenomation?
Which factors that affect the toxicity and duration of the symptoms of scorpion envenomation?
What is the duration of symptoms from scorpion envenomation?
What are the sympathetic signs of a scorpion envenomation?
What are the parasympathetic signs of a scorpion envenomation?
What are the signs and symptoms of scorpion envenomation?
What are the autonomic symptoms of scorpion envenomation?
What are the cranial nerve effects of scorpion envenomation?
What are the somatic effects of scorpion envenomation?
What are the physical findings characteristic of scorpion envenomation?
What are physical findings characteristic of scorpion envenomation in children?
How is scorpion envenomation without neurological symptoms graded?
How is scorpion envenomation with neurological symptoms graded?
What are the signs and symptoms of scorpion envenomation at the sting site?
How does the venom dose affect the clinical manifestations of scorpion envenomation?
What are the central nervous system signs of scorpion envenomation?
What are the autonomic nervous system signs of a scorpion envenomation?
What are the somatic signs of a scorpion envenomation?
What are the signs of cranial nerve involvement in scorpion envenomation?
What are the peripheral nervous system signs of scorpion envenomation?
What are the cardiac symptoms of scorpion envenomation?
What causes cardiovascular collapse in scorpion envenomation?
What are the respiratory signs of scorpion envenomation?
What are the possible allergic reactions to scorpion envenomation?
What are the GI symptoms of scorpion envenomation?
What are the genitourinary symptoms of a scorpion envenomation?
What are the hematological signs of scorpion envenomation?
What are the metabolic signs of scorpion envenomation?
How does scorpion envenomation complicate pregnancy?
Which symptoms of scorpion envenomation are predictive of hospital admission?
Which symptomatology is species specific in scorpion envenomation?
What are the complications of scorpion envenomation?
DDX
What are the differential diagnoses for Scorpion Envenomation?
Workup
What is the role of lab studies in the workup of scorpion envenomation?
What is the role of imaging studies in the workup of scorpion envenomation?
What is the role of arterial blood gas in the workup of scorpion envenomation?
Which findings on pulmonary artery catheterization are characteristic of scorpion envenomation?
What is the role of serial spirometry in the workup of scorpion envenomation?
What is the role of electrocardiography in the workup of scorpion envenomation?
Which findings on spinal tap is characteristic of scorpion envenomation?
Which histologic findings are characteristic of scorpion envenomation?
Treatment
What is included in prehospital care for patients with scorpion envenomation?
What is included in emergency department care for patients with scorpion envenomation?
What are the grades of Centruroides scorpion envenomation?
What is the Hector Hospitalization score for Androctonus australis?
How is scorpion envenomation treated?
What is included in localized treatment of scorpion envenomation?
What are the systemic treatment options for scorpion envenomation?
What is the role of insulin in the treatment of scorpion envenomation?
What is the role of barbiturates and benzodiazepine in the treatment of scorpion envenomation?
Which treatments have not proven beneficial in the treatment of scorpion envenomation?
What is the role of antivenom in the management of scorpion envenomation?
How quickly do symptoms dissipate following antivenom administration for scorpion envenomation?
What is the effectiveness of antivenom for scorpion envenomation?
What is included in inpatient care of patients with scorpion envenomation?
When is transfer needed for the treatment of scorpion envenomation?
Which medical personnel should be consulted in the management of scorpion envenomation?
What activity modifications are needed during the treatment of scorpion envenomation?
How is scorpion envenomation prevented?
What is included in long-term monitoring following treatment of scorpion envenomation?
Medications
What are the goals of drug treatment for scorpion envenomation?
Which medications are used in the management of scorpion envenomation?
What is the efficacy of antivenom in the treatment of scorpion envenomation?
How is allergy to antivenom determined prior to treatment of scorpion envenomation?
Why is bark scorpion antivenom for scorpion envenomation no longer produced?
How should antivenom be administered for the best result in the treatment of scorpion envenomation?
Which antivenom has received FDA approval for treatment of scorpion envenomation?
Which medications in the drug class Barbiturates are used in the treatment of Scorpion Envenomation?
Which medications in the drug class Toxoids are used in the treatment of Scorpion Envenomation?
Which medications in the drug class Antivenins are used in the treatment of Scorpion Envenomation?
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Centruroides limbatus, identified by Scott Stockwell, PhD. A small barb at the base of the stinger may be helpful in identifying Centruroides or Tityus species, although its presence is variable. Photo by Sean Bush, MD.
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Centruroides species. Note the slender pincers generally characteristic of scorpions from the family Buthidae. Photo by Sean Bush, MD.
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Scorpions from the family Buthidae (which includes almost all of the potentially lethal scorpions) generally can be identified by the triangular sternal plate. In other families of scorpions, this feature is more square or pentagonal. Photo by Sean Bush, MD.