Establishment of Natural History of Scorpion Envenomation
Condition: Scorpion Sting Envenomation
MeSH terms: Poisoning; Scorpion Stings
Study type: Observational

Summary: 
      This retrospective study was conducted to collect data from approximately 100 patients from 6
      months to 18 years of age who were stung by a scorpion but were not treated with antivenom.
      The study consisted of a review of hospital records of patients who were admitted for
      intensive care management of scorpion envenomation, at the only two hospitals in North
      America known to admit children routinely for scorpion sting management without antivenom.
      The standard of care consisted of symptomatic and supportive care, including airway
      maintenance, fluid and electrolyte support and, if necessary, sedation.
    

Detailed description: 
      The study objective was to document the clinical syndrome of scorpion envenomation in the
      absence of antivenom treatment in pediatric patients. This was done to establish historical
      control data on the time from sting to the time of resolution of signs of envenomation. These
      historical control data are intended to be used for comparison with Alacramyn treated
      patients in two prospective studies being conducted in Mexico and the U.S.for which a control
      population could not otherwise be established.

      The total duration of clinically important systemic signs of envenomation was determined
      based upon overall investigator assessment of the last signs of any respiratory compromise,
      any pathological agitation or other indicator of continuing illness (e.g., continuing need
      for sedative administration).

      To facilitate comparison of these historical data with prospective open label trials,
      periodic assessments of the overall presence or absence of clinically important signs was
      performed. Periodic assessments were also performed for each individual component indicator
      of respiratory compromise and of pathological agitation, when available.

      A research nurse reviewed hospital discharge diagnoses for all pediatric charts coded for
      "scorpion sting". For these cases demographic, diagnostic, and therapeutic data were entered
      on the case report form (CRF) as well as data necessary to assess compliance with study
      inclusion and exclusion criteria.

      A physician subinvestigator reviewed the research nurse's findings for the key outcome
      indicators, which consisted of clinically important systemic signs of scorpion envenomation
      and adjunctive sedation treatment (dose and timing of dose) when medical judgment was
      required.
    

Intervention name(s): None, this is an observational study
Intervention type(s): Other
Observational model: Case-Only
Time perspective: Retrospective
Sampling method: Non-Probability Sample
Study population: 
        Male and female patients 6 months to 18 years of age who presented for emergency treatment
        of scorpion sting and who had clinically important systemic signs of envenomation were
        included.
      
Keywords: scorpion; sting; envenomation; antivenom