clinical evaluation of the effectiveness of antivenom in scorpion envenomation

ABSTRACT

From 1985 to 1991, 950 cases of scorpion stings were admitted and treated with 0 to 1 ampule of scorpion antivenom at King Fahd Hospital, Al Baha. Antivenom policy was changed in mid 1991, therefore, from January, 1992 to December, 1998, 968 admitted cases of scorpion stings were treated with 5 or more ampules of antivenom. All patients with severe envenomation and pulmonary edema were treated in the intensive care unit. The protocol of treatment had remained the same [1985 - 1998], except for prompt high antivenom dosage. The occurrence of pulmonary edema and cardio-pulmonary arrest in the two years preceeding the policy change [1990-1991] was compared with the period when high dose serotherapy was made mandatory [1992-1998]. After the new antivenom dose, mortality rate fell from 16 of 950 [1.7%] to 0 of 968 [p=0.00015]; occurrence of pulmonary edema decreased from 18 of 162 [11.1%] in 1990-1991 to 12 of 968 [1.2%] in 1992-1998 [p<0.001] and cardio-pulmonary arrest from 7.4% to 0.4% [p<0.001]. The last death recorded due to scorpion sting was of a patient in 1991 who had received no antivenom. The excellent outcome is attributed to scorpion antivenom