Scorpion envenomation in eastern Saudi Arabia

To prospectively collect data on the initial presentation of victims of scorpion envenomation during the deployment of US forces to Saudi Arabia in support of Operation Desert Shield.

A four-month prospective analysis of the circumstances, initial clinical signs and symptoms, treatment rendered, and subsequent clinical course of patients suffering scorpion envenomation. Data were analyzed using descriptive statistics. Scorpions were identified from physical remains.

Open desert in eastern Saudi Arabia 250 miles northeast of Riyadh. Ten battalion aid stations supporting a US armored cavalry division provided first-echelon medical care to 7,000 soldiers.

The 40 male and three female patients were American military personnel between 19 and 33 years old.

The constraints of military action precluded an interventional protocol. Each medical officer rendered appropriate medical care according to experience.

During 118 days of encampment, 57 cases were reported, with 43 containing sufficient data for inclusion in the study. Thirty-six (63%) cases occurred during six weeks of initial fortification activity in open desert. Thirty-five victims (79%) presented for medical care within one hour after envenomation. The most common local symptoms and signs were pain (100%) and erythema (63%). The prevalent systemic symptom was apprehension (44%), with tachycardia (72%) and hypertension (58%) the prevalent systemic signs. With one exception, neurologic and cardiorespiratory complications were transient and responded well to fluid support and low doses of beta-sympathomimetics, parasympathetic antagonists, H1 blockers, and analgesics.

The local and systemic response by victims in this study are consistent with previously documented cases of scorpion envenomation. In adult patients without serious prior adverse medical conditions, intervention is best limited to supportive measures.