Define Scorpion Sting. Describe its clinical features, management, grading and prevention.

Definition

Scorpion sting envenomation (notably the Indian red scorpion) causes an autonomic storm from massive catecholamine release, and can be life-threatening in children.

Clinical Features

• Severe local pain at the sting site.
• Autonomic overactivity — sweating, hypertension, tachycardia, cool extremities, priapism, vomiting, hypersalivation.
• Life-threatening — myocarditis and pulmonary oedema (with respiratory distress).

Management

• Prazosin (an alpha-blocker) — the drug of choice (counters the autonomic storm and reduces pulmonary oedema).
• Scorpion antivenom (where available/indicated); analgesia for local pain.
• Manage pulmonary oedema/heart failure; supportive/intensive care as needed.

Danger — Cardiopulmonary Effects

The most feared complications are myocarditis and pulmonary oedema, which can cause rapid deterioration; prazosin reduces afterload/preload and counteracts the catecholamine surge, improving outcomes.

Prevention

Many paediatric emergencies are preventable — safe storage of poisons/medicines, supervision, protective measures and prompt first aid substantially reduce serious harm and mortality.