Lack of Scorpion Antivenom Leads to Increased Pediatric ICU Admissions

Riley, Bradley D.; LoVecchio, Frank; Pizon, Anthony F.

doi:10.1016/j.annemergmed.2005.11.042

Cited by 16 publications

(9 citation statements)

References 4 publications

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“…Although deaths have been rare recently, ICU admissions increased considerably when Arizona supplies of the goatderived antivenom ran out in 2004 [23]. In 2007, a clinical trial of the equine Centruroides Immune F(ab') 2 antivenom began (ClinicalTrials.gov Identifier NCT00624078) [24].…”

Section: Discussionmentioning

confidence: 99%

Nationwide Scorpion Exposures Reported to US Poison Control Centers from 2005 to 2015

Kang

Brooks

2016

J. Med. Toxicol.

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Section: Discussionmentioning

confidence: 99%

Nationwide Scorpion Exposures Reported to US Poison Control Centers from 2005 to 2015

Kang

Brooks

2016

J. Med. Toxicol.

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“…sculpturatus is the only scorpion that produces clinically significant toxicity in the USA and is endemic to the southwest. In recent decades, hospital admission following scorpion sting was infrequent throughout most of Arizona due to use of an anti-Centruroides whole IgG antivenom, but after this antivenom became unavailable in 2004, intensive care admissions for scorpion envenomation dramatically increased, with one report citing a nearly 500 % increase in admissions over baseline [4].…”

Section: Discussionmentioning

confidence: 99%

“…This antivenom was used in emergency departments throughout much of the state, rapidly reversing clinical effects and typically avoiding hospital admission [4]. However, its use was associated with a significant incidence of anaphylaxis and delayed hypersensitivity.…”

Section: Introductionmentioning

confidence: 99%

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Clinical Course of Bark Scorpion Envenomation Managed Without Antivenom

O’Connor

Ruha

2012

J. Med. Toxicol.

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Bark scorpion envenomation is potentially life threatening in children and traditionally treated with antivenom (AV). We sought to describe the clinical course, management, complications and outcome of children with severe scorpion envenomation treated with supportive care during a period when AV was unavailable. A retrospective chart review was performed, all children presenting to a referral hospital between September 1, 2004 and July 31, 2006 with severe scorpion envenomation not receiving AV, were included. A standardized data abstraction form was used to record time of symptom onset, time to healthcare facility (HCF), clinical findings, treatment, complications, and length of stay. Eighty-eight patients were included with mean age of 3.7 years (0.33-12). Mean time to symptom onset was 20 min (0-130) and mean time to HCF was 79 min (10-240). Incidence of clinical manifestations include: neuromuscular agitation, 100 %; opsoclonus, 97 %; hypersalivation, 81 %; tachycardia, 82 %; hypertension, 49 %; vomiting, 38 %; fever, 28 %; respiratory distress, 33 %; and hypoxia, 18 %. Complications included rhabdomyolysis in 18 (20 %) and aspiration in 12 (13 %) patients. Intubation was required in 24 % of patients. The most frequently used agents to control symptoms were benzodiazepines (98 %) followed by opioids (69 %). Intravenous fluids were given to 84 %. Mean length of stay was 29 h (range, 6-73 h). There were no deaths. In addition to the classic findings of neuromuscular hyperactivity, opsoclonus, and hypersalivation, a high incidence of hyperadrenergic findings and respiratory compromise are noted in this series.A significant number of patients required mechanical ventilation. Benzodiazpines and opioids were the most common medications used to control symptoms.

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“…Clinical findings [10]. After this antivenom became unavailable, intensive care admissions for scorpion envenomation considerably increased with one study reporting a nearly 500 % increase in admissions over baseline [11]. Since Anascorp® rates are again low.…”

Section: Discussionmentioning

confidence: 99%