Middle East and North African Scorpions

Treatment of Scorpion Envenomations in the Middle East: Understanding the Stinging Controversy

“…6 Effects on the sympathetic nervous system may include tachycardia, hypertension, tachypnea, leukocytosis, and myocardial infarction. 1 Parasympathetic and skeletal motor nervous responses typically include tongue and muscle fasciculations, abdominal pain, gastric and pancreatic hypersecretion, nausea and vomiting, priapism, and occasionally, bradycardia. 1 Both L quinquestriatus (deathstalker) and Androctonus genus (fat tail) scorpions are associated more with cardiotoxicity (typically tachycardia and hypertension) than with neurotoxicity.…”

“…3,6,7 There are multiple grading and treatment guidelines for scorpion envenomations, but they are designed for understanding scorpion envenomations globally. 1,8 In reality, host nation protocols for scorpion envenomation treatment can vary by institution. Regardless, the mainstay of treatment for systemic symptoms in the Middle East is medical support, usually with prazosin and sometimes benzodiazepines, with the decision to administer antivenom being a difficult one.…”

“…Fat tail scorpion is the common name for scorpions of the genus Androctonus, also of the Buthidae family. 1 This scorpion is known for having a distinctive thick tail, although coloration can vary, underscoring the idea that accurately identifying scorpion species by visualization is difficult. 2 H lepturus, on the other hand, belongs to the Hemiscorpidae family and is a very poisonous scorpion found in Iran and nearby countries with a high mortality rate.…”

“…2 H lepturus, on the other hand, belongs to the Hemiscorpidae family and is a very poisonous scorpion found in Iran and nearby countries with a high mortality rate. 1,3 Scorpion venoms contain a mixture of peptide toxins that target ion channels and can cause neurotoxic and hemotoxic symptoms in humans. 4 These symptoms can be severe when a sufficient dose of venom is injected relative to the victim's mass, which explains why the fatality rate is 10 times higher in children than in adults.…”

“…Point-of-care ultrasound (POCUS) is an important tool that anesthesiologists, emergency physicians, trauma surgeons, and paramedics use to enhance patient care. 1 POCUS has been used extensively in the prehospital, emergency department, and perioperative settings. 2 We would like to demonstrate the combination of small wireless ultrasound devices with smart glasses to perform POCUS in austere environments.…”