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Toxicology

Scorpion

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Scorpion

  • These are eight-legged arthropods and possess a hollow sting in the last joint of their tail, communicating by Means of a duct with poisonous glands.
  • Worldwide, only about 30 of the estimated 1,500 species of scorpions produce venom toxic enough to be fatal. Mesobuthus tamulus an Indian red scorpion is the most lethal among all species
  • The venom is a
    • neurotoxin, acting on respiratory and vasomotor centres, nerve terminals, and end plates of muscles.
    • Haemolysins, and many other enzymes

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Scorpion(Cont.)

  • Clinical picture
          • Clinical manifestation is similar in all species but severity varies.
          • Burning radiating pain from the site of the sting may be the only complaint
          • Excessive sweating salivation & vomiting,
          • Systemic manifestations such as hypertension/ tachycardia, pulmonary oedema and cool extremities
          • Some times giddiness, faintness, muscular weakness, diarrhoea, convulsions, mental disturbance, shock and rarely death
          • Acute kidney injury and or pancreatitis due to scorpion sting is reported

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Treatment Scorpion Sting

  • Clean the wound with mild soap and water.
  • Apply a cool compress to the affected area.
  •  Immobilize the limb/area on which sting
  • For pain give Crocin/ Calpol tab. Some times opiates may be required
    • Avoid aspirin or Ibuprofen
    • Antihistaminics like Benadryl / avil may be given to reduce swelling

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TREATMENT

  • Oral Diazepam to treat anxiety and potentiate analgesics
  • Rapid acting alpha blocker Prazosin 3 hourly if sympathetic manifestations appear
  • Pulmonary oedema treated with propped up position, oxygen, and intravenous sodium nitroprusside drip or nitroglycerine drip.
  • Oral or parenteral rehydration dopamine may be required to combat shock

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