Clinical Profile and ECG Changes in Scorpion Envenomation
2007
1. In this study, the incidence of scorpion sting in males(56.6%) was found to be higher than females.
2. The incidence of scorpion envenomation was found to be maximum in the age group of 31-40 years (33%) and 21-30 years (29%). This indicates the risk of exposure to the scorpion sting at work place and during household chores.
3. More patients presented to the Poison center in the night (53%) than in the morning. This is in line with the predatory pattern of the scorpions and the risk of disturbing scorpion homes in the darkness of the night.
4. Fifty –nine percent of the patients presented with Grade 1 envenomation.
Seven percent with Grade 2 and thirty four percent with Grade 3 envenomation.
5. Hand was the commonest site of sting in this study. Most of the scorpion stings were accidental and occurred indoors.
6. Pain (83%) and Tachycardia (19%) were the commonest presenting symptom and sign respectively.
7. Sinus tachycardia (6%) was the commonest ECG abnormality seen in the study.
8. There was no significant difference in clinical presentation with respect to age group and gender.(P value=0.20447).
9. The patients who presented late to the emergency room after scorpion sting were found to have greater morbidity.(P value<0.001).
10.There was statistical significance in the relationship between ECG change and biochemical markers CPK and CPK-MB.
11.Patients with Grade 1 envenomation treated with local infiltration of lidocaine at the pain site, anxiolytics , antibiotics and observed. Those with Grade 3 envenomation required oxygen and managed with intravenous fluids and inotropic agents for shock. One of the three patients with pulmonary edema required mechanical ventilation.
12. The transient hyperglycemia and hypertension observed in patients with severe envenomation resolved in 48 hours.
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