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Author Spotlight: Optimizing Scorpion Venom Extraction for Antivenom Production
Published on: October 6, 2023
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Risk-Stratified Observation After Asymptomatic Paediatric Scorpion Envenomation May Safely Reduce Emergency
Inbal Kestenbom1, Shaked Bar-Moshe1, Gidon Test1
1Pediatric Emergency Department, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel.
Acta Paediatrica (Oslo, Norway : 1992)
|September 19, 2025
Summary
Children with mild scorpion envenomation rarely develop delayed symptoms, suggesting shorter emergency department observation times are safe. A risk-stratified approach can optimize care for pediatric scorpion stings.
Area of Science:
- Pediatric Emergency Medicine
- Toxicology
- Clinical Pediatrics
Background:
- Current emergency department (ED) protocols recommend 4-6 hours of observation for pediatric scorpion envenomation.
- Limited evidence supports these guidelines, especially for asymptomatic children.
Purpose of the Study:
- To evaluate the necessity of routine emergency department observation for children with scorpion envenomation.
- To assess the risk of delayed systemic symptoms in pediatric patients with varying envenomation severity.
Main Methods:
- Retrospective cohort study of 287 children in southern Israel over 15 months.
- Utilized a validated envenomation severity score to categorize patients.
- Compared outcomes between Grade 1 (mild) and Grade ≥2 (more severe) envenomation scores.
Main Results:
- 83% of patients had mild envenomation; <1% developed delayed symptoms, with 99% discharged.
- More severe envenomation cases were younger, had higher allergy prevalence, and 94% required hospitalization.
- Delayed symptoms in mild cases resolved with conservative management.
Conclusions:
- A risk-stratified approach considering age, time, allergies, and severity can safely shorten ED observation.
- Children with mild scorpion envenomation symptoms have a low risk of delayed complications.
- Optimizing ED observation time for pediatric scorpion stings is feasible.
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