Saturday, May 7, 2016

Q: 24-year-old male is admitted to ICU from ED. The Patient had scorpion bite 3 hours ago and required intubation in ED for the protection of Airway. Pharmacy notified you that anti-venom has been arranged and should be available in an hour. Which analgesia should be avoided?

Answer: Morphine

Morphine may cause histamine release with the administration of anti-venom. Fentanyl is a preferred choice of analgesia. It is commonly misconceived that scorpion venom without anti-venom would be fatal. Most adult patients survive with supportive treatment. Antivenom is recommended to decrease the duration of  symptoms and to avoid rare but possible life-threatening complications like blurred vision, slurred speech, tongue fasciculations, hypersalivation (causing aspiration and respiratory failure), abnormal eye movements, restlessness, fasciculations, alternating opisthotonos, and emprosthotonos, hyperthermia, pancreatitis and others.

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