Scorpions are a common arthropod found all over the world.
If threatened, a scorpion may use its long, flexible tail to sting a potential predator.
Frequently, people unknowingly come into contact with these species and experience the painful sensation of envenomation
An insect that has an elongated body and a segmented, curved tail tipped with a venomous stinger.
A sting can be fatal to a person who is allergic to it.
The toxicity of scorpion venom varies by species. A given species' venom may contain many chemicals, some toxic to insects, others toxic to mammals.
Scorpion species with smaller and more slender claws generally have more toxic venom.
Scorpion stings are much more dangerous for infants and small children.
Dr. Sachin Verma is a young, diligent and dynamic physician. He did his graduation from IGMC Shimla and MD in Internal Medicine from GSVM Medical College Kanpur. Then he did his Fellowship in Intensive Care Medicine (FICM) from Apollo Hospital Delhi. He has done fellowship in infectious diseases by Infectious Disease Society of America (IDSA). He has also done FCCS course and is certified Advance Cardiac Life support (ACLS) and Basic Life Support (BLS) provider by American Heart Association. He has also done a course in Cardiology by American College of Cardiology and a course in Diabetology by International Diabetes Centre. He specializes in the management of Infections, Multiorgan Dysfunctions and Critically ill patients and has many publications and presentations in various national conferences under his belt. He is currently working in NABH Approved Ivy super-specialty Hospital Mohali as Consultant Intensivists and Physician.
Medical toxicological aspects of snakes with emphasis on classification of snakes and their venom, identification of snakes, fatal dose, fatal period, signs and symptoms of snake bite, diagnosis of snake bite, management, post-mortem findings and medico-legal aspects especially of the common Indian snakes.
An insect that has an elongated body and a segmented, curved tail tipped with a venomous stinger.
A sting can be fatal to a person who is allergic to it.
The toxicity of scorpion venom varies by species. A given species' venom may contain many chemicals, some toxic to insects, others toxic to mammals.
Scorpion species with smaller and more slender claws generally have more toxic venom.
Scorpion stings are much more dangerous for infants and small children.
Dr. Sachin Verma is a young, diligent and dynamic physician. He did his graduation from IGMC Shimla and MD in Internal Medicine from GSVM Medical College Kanpur. Then he did his Fellowship in Intensive Care Medicine (FICM) from Apollo Hospital Delhi. He has done fellowship in infectious diseases by Infectious Disease Society of America (IDSA). He has also done FCCS course and is certified Advance Cardiac Life support (ACLS) and Basic Life Support (BLS) provider by American Heart Association. He has also done a course in Cardiology by American College of Cardiology and a course in Diabetology by International Diabetes Centre. He specializes in the management of Infections, Multiorgan Dysfunctions and Critically ill patients and has many publications and presentations in various national conferences under his belt. He is currently working in NABH Approved Ivy super-specialty Hospital Mohali as Consultant Intensivists and Physician.
Medical toxicological aspects of snakes with emphasis on classification of snakes and their venom, identification of snakes, fatal dose, fatal period, signs and symptoms of snake bite, diagnosis of snake bite, management, post-mortem findings and medico-legal aspects especially of the common Indian snakes.
Snake Bite,Rabies,Scorpion Bite PPT – Presented By Prof.Dr.R.R.deshpande on 1...rajendra deshpande
Snake Bite ,Rabies ,Scorpion bite are like urgency or Emergency type of conditions .This topics come under Toxicology or Agadtantra Subject of 2nd Year BAMS .This ppt will save the time to make notes from Huge books of Toxicology .This ppt is very useful for Ayurvedic students,Teachers,Doctors.Ready made information from this ppt will not only helpful for Examination point of view .But this ppt if Doctor download & save in his or her smart phone ,that will be like Ready Recknor in your practice .This ppt will help to diagnose ,to understand symptoms & signs & how to treat patient of Snake bite,Rabied dog bite ,Rat Bite,Scorpion bite . Download this ppt & send to many by what’s app Snake Bite ,Rabies ,Scorpion bite are like urgency or Emergency type of conditions .This topics come under Toxicology or Agadtantra Subject of 2nd Year BAMS .This ppt will save the time to make notes from Huge books of Toxicology .This ppt is very useful for Ayurvedic students,Teachers,Doctors.Ready made information from this ppt will not only helpful for Examination point of view .But this ppt if Doctor download & save in his or her smart phone ,that will be like Ready Recknor in your practice .This ppt will help to diagnose ,to understand symptoms & signs & how to treat patient of Snake bite,Rabied dog bite ,Rat Bite,Scorpion bite . Download this ppt & send to many by what’s app .
Various pests, fungi, weeds and rodents cause much harm to the production and storage of food grains
A large number of pesticides including insecticides, rodenticides, herbicides and fungicides are available in the market.
Snake Bite,Rabies,Scorpion Bite PPT – Presented By Prof.Dr.R.R.deshpande on 1...rajendra deshpande
Snake Bite ,Rabies ,Scorpion bite are like urgency or Emergency type of conditions .This topics come under Toxicology or Agadtantra Subject of 2nd Year BAMS .This ppt will save the time to make notes from Huge books of Toxicology .This ppt is very useful for Ayurvedic students,Teachers,Doctors.Ready made information from this ppt will not only helpful for Examination point of view .But this ppt if Doctor download & save in his or her smart phone ,that will be like Ready Recknor in your practice .This ppt will help to diagnose ,to understand symptoms & signs & how to treat patient of Snake bite,Rabied dog bite ,Rat Bite,Scorpion bite . Download this ppt & send to many by what’s app Snake Bite ,Rabies ,Scorpion bite are like urgency or Emergency type of conditions .This topics come under Toxicology or Agadtantra Subject of 2nd Year BAMS .This ppt will save the time to make notes from Huge books of Toxicology .This ppt is very useful for Ayurvedic students,Teachers,Doctors.Ready made information from this ppt will not only helpful for Examination point of view .But this ppt if Doctor download & save in his or her smart phone ,that will be like Ready Recknor in your practice .This ppt will help to diagnose ,to understand symptoms & signs & how to treat patient of Snake bite,Rabied dog bite ,Rat Bite,Scorpion bite . Download this ppt & send to many by what’s app .
Various pests, fungi, weeds and rodents cause much harm to the production and storage of food grains
A large number of pesticides including insecticides, rodenticides, herbicides and fungicides are available in the market.
Snake bite and its management by first aid and antivenomShwetaKhadka
about snake bite ,venom,types of venom,first aid,antivenom,and management ,epidemiology ,dosage and route of antivenom administration , anaphylactic reaction due to antivenom , general symptoms of snake bite,immobilization process , formation of antivenom
Clinical features & Management of ARTHROPODS STING AND BITES.pptxvuyyuribhaargavi
Envenomation is the process by which venom is injected by the bite or sting of a venomous animal such as a snake, scorpion, spider, or insect. Arthropods can infest human skin ex: head lice.
Arthropods can inflict bites and stings. They can carry diseases such as malaria, yellow fever and filariasis. Order of insects belongs to stings are:
a) Hymenoptera - bees, wasps, hornets, fire ants.
b)Scorpionida- scorpions.
Hymenoptera venom contains
Biogenic amines (histamine, 5-HT and acetylcholine),
enzymes (phospholipase A and hyaluronidase)
toxic peptides (kinins in wasps, mast cell degranulating peptides in bees).
Clinical features & Treatment
1) Local reaction:
Clinical features
Local pain
Edema
Airway obstruction
By wasps - severe cutaneous infection & cellulitis (serious bacterial infection, skin is swollen and inflamed)
Treatment:
Remove stings
Local application – 20% Aluminium sulfate
Antihistamines – Diphenhydramine (500mg), Chlorpheniramine (4mg)
2) Allergic reaction – Tingling sensation, flushing, vomiting, Urticarial skin rash, pedal edema. Sometimes fever, malaise, renal failure.
Treatment: 0.1% adrenaline
Antihistamins, Corticosteroids
Cardiac monitoring, Analgesics, Haemodialysis- for renal failure.
Toxic reaction: Multiple stings
vasodilation, Hypotension, Fatigue, Diarrhoea, Headache
seizures, Delayed toxic reaction:
Renal failure, coagulopathy.
Treatment : Parenteral antihistamins.
Large dose corticosteroids.
Bronchodilators
Haemo dialysis.
Vit k for coagulopathy
SCORPION:
Scorpions differ in colour from straw yellow or light brown, to black.
Tail of the scorpion terminates into Bulbous enlargement called telson, which contains the stinger and venom apparatus.
venom
The main toxins include phospholipase, acetylcholinesterase, hyaluronidase, serotonin, and neurotoxins.
The venom of Buthus species of India contains phospholipase A, which causes gastrointestinal and pulmonary haemorrhages, and disseminated intravascular coagulation ( presence of severe abnormal blood clots in blood vessel)
Mode of Action
Affects Na+ channels with prolongation of Action Potentials.
Depolarisation of Nerves of both Adenergic & PSNS
Clinical features:
Local: Rapidly developing local pain, swelling, edema, lymadenopathy.
Systemic: Autonomic stimulation, Mydriasis, Profuse sweating, Excessive salivation
Urticaria, Hypertension, Convulsions, Priapism, nausea, Pulmonary oedema may develop within 2 to 3 hours leading to death, Intracerebral haemorrhage,
TREATMENT:
1) During transport to hospital:
Immobilize the affected extremity. Do NOT apply tourniquet.
Local application of ice is beneficial in relieving pain. Prolonged cryotherapy is however contraindicated.
A negative-pressure suction device may be used, if available
2)On Arrival at Hospital:
Rep. failure- Mechanical Ventilation, administer oxygen.
Pain- PCM/Morphine tabs.
Allergy- Antihistamines.
Nifidepine 10 to 20 mg (adults)
prazocin HCL, Dopamine, Diazepam, Metoclopramide, Antivenom therapy
This pptx is on recognition of different snakes, snake bite management particularly in children. At the end of the slide show you will definitely able to recognize and manage snake bites.
A lysosomal storage disease caused by acid sphingomyelinase deficiency (ASMD), which catalyzes the hydrolysis of sphingomyelin (SM) to ceramide and phosphocholine.
Most pNENs - sporadical.
Some individuals may have a genetic predisposition to developing pNENs.
But may not be expressed unless it is triggered or activated under certain circumstances, such as due to certain environmental factors.
As part of a larger genetic syndrome such as; 1. Multiple endocrine neoplasia type I (MEN1), 2. Von Hippel-Lindau syndrome (VHL) or 3. Neurofibromatosis type I (NF-1).
Scleroderma is a group of autoimmune diseases that may result in changes to the skin, blood vessels, muscles, and internal organs.
The disease can be either localized to the skin or involve other organs in addition to the skin.
Symptoms may include areas of thickened skin, stiffness, feeling tired, and poor blood flow to the fingers or toes with cold exposure.
Carpal tunnel syndrome (CTS) is the most common peripheral nerve entrapment syndrome.
Characterised by numbness and tingling of the radial 3 ½ digits.
Found in 1% of the general population
Increased incidence is noted in women, the elderly and pregnant patients.
1. Undescended Testis : Along the normal path, but not reached scrotum.
2. Retractile Testis : Hyperreflexic Cremaster
3. Ectopic Testis : Deviation from normal path of descent
Absence of testis in scrotum since birth
Hemiscrotum empty, hypoplastic
Decreased caliber and force of the stream
Problems starting(hesitancy) and stopping urine stream; post-void dribbling
Impaired bladder emptying
- high risk of infection and hydronephrosis
Urinary retention
Incontinence
Nocturia; polyuria / Dysuria
Hypertrophy of bladder wall muscle
- increased risk for bladder diverticula
Microscopic hematuria maybe present
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We specializes in exporting high quality Research chemical, medical intermediate, Pharmaceutical chemicals and so on. Products are exported to USA, Canada, France, Korea, Japan,Russia, Southeast Asia and other countries.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
2. Introduction
• Scorpions are a common arthropod found
all over the world.
• If threatened, a scorpion may use its long,
flexible tail to sting a potential predator.
• Frequently, people unknowingly come into
contact with these species and experience
the painful sensation of envenomation.
5. 93
Scorpion Bite
• 2 Types of Scorpion
• Black – 99% -- Pain is severe ,but not
fatal .
• Red Scorpion – found in
Guhagar,Chiplun ,Kokan area of
Maharashtra state of India,Pondechari
• This bite can be Fatal
6. Etiology
• While there are thought to be about 1750
species of scorpions in the world, only 25
are considered to be lethal to humans.
• In most cases, the sting of a scorpion causes
pain but is relatively harmless to a healthy
adult.
• Species found in Asia, Africa, and South
America may need medical attention due to
the potential toxic effects of their venom.
7. Epidemiology
• The effect of the scorpion sting is highly
dependent on the species.
• Species like Centruroides and Parabuthus
cause neuromuscular issues, Buthus,
Mesobuthus, & Androctonus exhibit life-
threatening cardiovascular effects.
• These worrisome effects are mostly seen in
the elderly and even more so in infants and
young children.
8. Pathophysiology
• Grade 1: Local pain and paresthesias at the sting site.
The puncture wound may not be noticeable in this
grade. The "tap test" may confirm a provider's
suspicion by distracting the patient and tapping on the
area of the sting, causing increased pain. This does
not occur with other species. Care is limited to
analgesia.
• Grade 2: Local pain and paresthesias at the sting site
as well as proximally. Recommended care again
includes analgesia with optional anxiolytics if needed.
9. CONT..
• Grade 3: Grade 2 with added cranial nerve (increased
oral secretions, blurry vision, rapid tongue movement,
nystagmus) or skeletal neuromuscular dysfunction
(flailing of the extremities and tetanus-like arching of
the back). These patients require analgesia and
anxiolytics as well as anti-venom.
• Grade 4: Unlike grade 3 envenomation where the
patient will experience either cranial nerve or skeletal
muscle dysfunction, grade 4 envenomation include both.
This can cause hyperthermia, rhabdomyolysis,
pulmonary edema, and multiple organ failures. Again,
anti-venom is critical in this situation.
10. Symptoms of Scorpion Bite
• Local – more severe than snake bite –
• pain, oedema & reddening
• Systemic – Nausea, vomiting, restlessness,
fever ,convulsions, coma, cyanosis
• The site of the bite is identified as –
Pinpoint puncture spot ,local sweating &
oedema
97
11. Toxicokinetics
• Less than 10% of scorpion stings cause systemic
symptoms & can be serious.
• Neurotoxins are the mainstay of symptomatology
in envenomation.
• The venom of some species can cause prolonged
depolarization by causing incomplete inactivation
of sodium channels resulting in a slow influx of
sodium.
• This then leads to membrane hyper-excitability and
unregulated axon firing.
12.
13. History and Physical
• Most scorpion stings cause a local inflammatory
reaction and pain.
• Seizure-like activity in the patient .
• Motor hyperactivity of the pharyngeal muscles and
uncontrolled diaphragmatic and intercostal
neuromuscular activity may be seen.
• Cardiopulmonary effect
• Tachycardia
• Pulmonary edema,
• Cardiogenic shock
14. Evaluation
• History and physical most commonly diagnose
scorpion stings.
• Usually, the patient can visualize the scorpion, and
the practitioner will observe an erythematous area
on the skin with local inflammation.
• Numbness and weakness at the site may also be
seen.
• CBC, CMP, PT/INR, PTT, and lipase.
• Laboratory studies are usually reserved for patients
with severe (grade 3 to 4) envenomations.
15. Management
• Most stings only require supportive therapy including
ibuprofen, cleaning of the sting area, and tetanus prophylaxis.
• Patients should be observed for at least 4 hours, but the
onset of life-threatening symptoms occurs much quicker in
children, with an average of 14 minutes.
• In patients with severe envenomation displaying symptoms
such as hypersalivation, clonus, rapid eye movements, or
restlessness, immediate intervention is critical.
• These patients may need endotracheal intubation due to the
possibility of rapid onset severe pulmonary edema.
• As cardiogenic shock can complicate this, administration of
dobutamine has been shown to be helpful.
16. CONT..
• Intravenous benzodiazepines may be used if the patient
displays muscle spasticity.
• Antivenom is reserved for patients displaying skeletal muscle
or cranial nerve dysfunction who are stung by Centruroides
scorpions. It is available in the United Staes, under the name
Anascorp, which is intravenous scorpion-specific F(ab’)2
equine antivenom. The recommended dose is three vials,
followed by an additional two if symptoms continue.
• Complications are low and comprise mostly serum sickness
(0.5%). Anascorp is considered much safer than the previous
antivenom, which was marketed in 1965 and taken off
shelves in 2001 due to its high rates of anaphylaxis (3.4%). .
17.
18. If a patient is observed for 4 hours and is
determined to have a mild sting, is
tolerating oral intake, and has adequate
pain control, the patient may be safely
discharged home with return precautions.