Classification of clinical consequences of scorpion stings: consensus development

Abstract

The objective of our consensus process was to develop a unique classification of the natural history of scorpion stings and their clinical signs and symptoms. The technique used was an adapted Delphi approach completed by a nominal group meeting. Researchers included in a study received a questionnaire in which we listed all terms used in published studies to characterize clinical consequences of scorpion stings and all signs and symptoms belonging to each class. For each term, experts had to judge the relevance for classifying clinical consequences of scorpion stings and state whether they agreed with the terminology; they could also propose new terms or classes. For each sign or symptom, they had to choose in which class it belonged and also propose if any other sign or symptom should be added. Sixteen researchers participated. Consensus was reached to include four classes: local manifestations; minor systemic manifestations; major systemic manifestations; lethal envenomation. Signs and symptoms associated with each class were defined. A second Delphi round is planned to define indicators to follow the epidemiological situation within and across countries and to develop recommendations for an optimal management of scorpion envenomations. These consensus-based tools should facilitate development of international clinical studies.

A Death after Scorpion Envenoming: ARDS

“…Severe forms of neuronal, cardiac, and respiratory abnormalities and related deaths are at the forefront [5]. Within neuronal abnormalities; autonomic storms, paralysis and coma of somatic/respiratory muscles, bradiarrhythmia in heart abnormalities, left ventricular failure, acute myocarditis, cardiogenic shock [6].…”

Scorpion Sting Envenomation

“…Many grading systems have been suggested 10,11 to assess severity,for planning therapy and predicting mortality. These were specifi c for a species but in 2011 a consensus statement was made based on experience of 16 scientists who were representatives of endemic countries.This was suitable for all species 11 .…”

“…These were specifi c for a species but in 2011 a consensus statement was made based on experience of 16 scientists who were representatives of endemic countries.This was suitable for all species 11 . The use of grading system is mainly to simplify the treatment.…”

Distribución de los hallazgos de escorpiones en la Ciudad de Buenos Aires en el período 2001-2012 y sus implicancias sanitarias

“…1 Son la causa estimada de 1 500 000 casos y 2600 muertes anuales. 2,3 De las más de 1500 especies de escorpiones conocidas, solo la picadura de algo más de 30 representa un riesgo para la salud humana.…”

“…4 Las estadísticas de diversos países muestran que solo el 10% de las picaduras de escorpiones provocan envenenamientos y serían responsables de alteraciones generales en los seres humanos. 1 Esto último es congruente con observaciones realizadas en A r g e n t i n a e n c u a n t o a l u s o d e antiveneno respecto a las notificaciones de accidentes. 5 Aunque la mayor cantidad de picadas mundialmente se producen en jóvenes y adultos, la mortalidad pediátrica es diez veces mayor.…”