{"id":71,"date":"2010-01-21T06:29:33","date_gmt":"2010-01-21T00:59:33","guid":{"rendered":"http:\/\/www.snake-scorpion.com\/?page_id=71"},"modified":"2010-01-21T06:29:33","modified_gmt":"2010-01-21T00:59:33","slug":"2-1-general","status":"publish","type":"page","link":"https:\/\/doctorbruno.info\/snake-bite-scorpion-sting-protocol\/section-ii-scorpion-sting\/2-1-general\/","title":{"rendered":"2.1 General"},"content":{"rendered":"

Introduction
\nScorpion sting is a life threatening medical emergency. The effect of envenomation
\nis greatest among children below 5 years of age. Adults too can succumb to scorpion
\nsting. Many social and environmental factors contribute to scorpion sting. Hence, it
\nbecomes an important public health problem. The epidemiology, presenting features,
\nclinical course, complications, therapeutic response and outcome are variable in
\ndifferent series. However, early recognition and appropriate intervention infl uence the
\noutcome. Hence, scorpion sting deserves special attention and cases should never be
\ntaken lightly.
\nThough the research on scorpion venom and knowledge on treatment of scorpion
\nsting have advanced, these newer ideas are yet to reach the health care provider and
\nthe community. In this context, it is worthwhile to remember Dr.H.S.Bawaskar, a
\nprivate practitioner from Maharashtra who for the fi rst time in world has introduced
\nthe usefulness of alpha blocker in scorpion sting nearly 25 years ago. This has been
\naccepted globally now in the treatment of scorpion sting.
\nEpidemiology
\nIn general for every case of snakebite, there may be 10 or more numbers of scorpion
\nstings. If that is the case, the number of cases of scorpion sting may run to millions.
\nThere is no reliable statistics on the scorpion sting in India. Scorpion sting is underreported.
\nPublished reports are institution based, hence include only serious cases of
\nscorpion sting treated in such institutions. As most of the cases of scorpion sting have
\nmild symptoms, the general practitioners or family physicians or a traditional medical
\npractitioners provide treatment and they never appear in health statistics.
\nIn Mexico, 1000 deaths due to scorpion sting occur per year whereas in USA four
\ndeaths were reported in 11 years. Of the 13,000 stings reported in USA, majority was
\ndue to non lethal scorpions. Most deaths occur during the fi rst 24 hours of the scorpion
\nsting and are secondary to respiratory and cardiovascular failure. Children and elderly
\nare at great risk of death due to their decreased physiological reserve. Death due to
\nscorpion sting occurs in 25% of children below 5 years, if not treated, whereas only
\n1% of scorpion stings are lethal to adults.
\nIn India too, deaths due to scorpion sting occurs across the country but do not get
\ndue attention. Larger the scorpion population, greater is the number of scorpion sting
\ncases. Scorpion stings are reported more from rural areas and the rural to urban ratio
\nis approximately 3:1. Mostly stings occur between 6 P.M. to mid-night and between
\n6 A.M. to 12 Noon, which correlate very well with human activity. Scorpion sting
\noccur more in temperate and tropical zones, and more during summer than winter.The Institute of child health, Madras Medical College, Chennai, has recorded nearly
\n1900 cases between 1980 and 1999 and the death rate varied from 4 to 7%. Of the 727
\ncases of scorpion stings treated during the period of 2000-2007 which included 406
\nmales and 321 females [M: F= 4:3]; the death among them were 11 and 8 respectively.
\nThe death rate in children due to scorpion sting was 2% which has come down from
\n4 to 7% earlier.
\nIn general, male to female ratio of scorpion sting is approximately 2:1 but females
\nsuffer more due to lower body weight. There is no racial predilection but clinical
\nsymptoms, course, and outcome vary because of individual\u2019s genetic constitution and
\nother factors [vide infra]. Human stinging occurs accidentally, when scorpions are
\ntouched, threatened, cornered or disturbed (stepped upon) while in their hiding places.
\nSo, people involved in handling construction materials, carpentry works, clearing
\nbushes or house cleaning as well as children playing nearby these areas are susceptible
\nto scorpion sting.
\nEco- biological aspects of scorpion
\nScorpions are shy creatures and not aggressive by and large. These are nocturnal
\ncreatures and hunt for their prey at night. Scorpions hide normally in crevices and
\nburrows during daytime to avoid light. Scorpions are found elsewhere outside the
\nenvironmental range. eg., accidentally crawl into luggage, boxes, containers, or shoes,
\npile of bricks, wooden materials, fi rewood, etc. They may also be transported in
\ntraveller\u2019s luggage and cargo.
\nThere are about 1500 scorpion species of which 50 are dangerous. In India 86
\nspecies of scorpion have been identifi ed. Among them, Mesobuthus tamulus and
\nPalamneus swammer-dami are important medically. Except Hemiscorpius species,
\nall lethal scorpions belong to the family called the Buthidae. The lethal members
\nof Buthidae family include the genera of Buthus, Parabuthus, Mesobuthus, Tityus,
\nLeiurus, Andractonus and Centruroides. Among the 30 scorpion species found in USA,
\nonly one of them is dangerous to human beings.
\nScorpions live in temperate and tropical regions especially between the latitudes of
\n50o north and 50o south of equator. The distinguishing features between lethal and non
\nlethal scorpions are provided in Table 16 given below.
\nTable No. 16: Distinguishing features of lethal and non-lethal scorpion<\/p>\n\n\n\n\n\n\n\n
Structure <\/strong><\/td>\nLethal Scorpion <\/strong><\/td>\nNon lethal scorpion<\/strong><\/td>\n<\/tr>\n
Sternum Shape<\/td>\nTriangular<\/td>\nPentagonal<\/td>\n<\/tr>\n
Pincers<\/td>\nWeak looking<\/td>\nStrong and Heavy<\/td>\n<\/tr>\n
Body<\/td>\nThin in a empathetic manner.<\/td>\nThick<\/td>\n<\/tr>\n
Tail<\/td>\nThick<\/td>\nThin<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Scorpions use their pincers to grasp the prey. It arches its tail over its body and
\nstings into its prey. Thus it injects its venom, sometimes more than once. The venom
\nglands are situated in the tail. The striated muscles in the stings regulate the amount of
\nvenom injected. When entire venom is used, it takes several days to replenish venom.
\nScorpion with large venom sacs such as Parabuthus species can even squirt their
\nvenom.
\nDistribution of various species of scorpions
\nButhus is found in Mediterranean area, Parabuths in Western andSouthern Africa,
\nMesobuthus in Asia, Tityus in Central and South America, and Caribbean, Leiurus
\nin Northern Africa and Middle East, Andractanus in Northern Africa to Southeast
\nAsia, and Centruroides in South West USA, Mexico and Central America.
\nSocio cultural aspects
\nFor scorpion sting also, patients are taken for magico religious treatment where
\nmantras are chanted, herbal medicines are applied externally and \/ or given orally. Since
\nthe scorpion sting has mild effects in many, most of them improve with local practices.
\nHence the community has confi dence on the local \/ traditional practitioner or priest. If
\nthe pain continues or symptoms get aggravated or general condition deteriorates and
\nin children if crying or restlessness continues, the patients are brought to the hospital.
\nThus local practices contribute to delay in health seeking.<\/p>\n","protected":false},"excerpt":{"rendered":"

Introduction Scorpion sting is a life threatening medical emergency. The effect of envenomation is greatest among children below 5 years of age. Adults too can succumb to scorpion sting. Many social and environmental factors contribute to scorpion sting. Hence, it becomes an important public health problem. The epidemiology, presenting features, clinical course, complications, therapeutic response […]<\/p>\n","protected":false},"author":3,"featured_media":0,"parent":63,"menu_order":0,"comment_status":"open","ping_status":"open","template":"","meta":{"footnotes":""},"class_list":["post-71","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/doctorbruno.info\/snake-bite-scorpion-sting-protocol\/wp-json\/wp\/v2\/pages\/71","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/doctorbruno.info\/snake-bite-scorpion-sting-protocol\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/doctorbruno.info\/snake-bite-scorpion-sting-protocol\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/doctorbruno.info\/snake-bite-scorpion-sting-protocol\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/doctorbruno.info\/snake-bite-scorpion-sting-protocol\/wp-json\/wp\/v2\/comments?post=71"}],"version-history":[{"count":0,"href":"https:\/\/doctorbruno.info\/snake-bite-scorpion-sting-protocol\/wp-json\/wp\/v2\/pages\/71\/revisions"}],"up":[{"embeddable":true,"href":"https:\/\/doctorbruno.info\/snake-bite-scorpion-sting-protocol\/wp-json\/wp\/v2\/pages\/63"}],"wp:attachment":[{"href":"https:\/\/doctorbruno.info\/snake-bite-scorpion-sting-protocol\/wp-json\/wp\/v2\/media?parent=71"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}