FIRST AIDS IN SCORPIONIC ENVENOMATION: A PROPOSAL BASED ON THE AUSTRALIAN EXPERIENCE WITH OPHIDIAN ENVENOMATION

Laboratorio de Neurofarmacología Celular, Centro de Biofísica y Bioquímica, Instituto Venezolano de Investigaciónes Científicas (IVIC) Apartado 21827, Caracas 1020A, Venezuela

A constant question when actions to take in patients envenomated by scorpions are explained is What can I do while I arrive to suitable medical attention center? This study extends the Australian experience on the treatmentof snake envenomation to that of Tityus envenomation. In Australia, the dangerous snakes to the man are members of the Elapidae family, which comprises terrestrial cobras and our corals. In Australia, the marine cobras of the Hidrophiidae family are also of medical importance. The snakes of these two families are extremely neurotoxic and produce the highest numbers of deaths throughout the world. These snakes and the scorpions possess polypeptidic venoms, whose most dangerous fractions have molecular weights ³8000D with scanty necrotic capacity. The polypeptides of snakes and scorpions also resemble in their tertiary structure, since they are globular polypeptides stabilized by disulphuric bounds. It has been demonstrated that peptides, such as those mentioned reach the systemic circulation by the lymphatic system, and not by capillary absorption to the venous system. This means that the blockade of the lymphatic return will maintain at the envenomation site most of the venom, particularly the toxic fractions (>7000D). We propose the following first aid procedures in scorpion envenomation in the extremities: 1) Wrap firmly the entire envenomed member with an elastic bandage or something similar. The bandage should be similar to the that used for a twisted ankle, with a pressure equivalent to 55 mmHg. The arterial and venous circulations should not be obstructed by the bandage. The bandage should be maintained up to the arrival in the hospital provided with antivenom and professionals that know how to use it. 2) The pricked member should be immobilized and splinted and maintained until removing the bandage. 3)The patient must stay in complete rest and be kept calm. 4) The patient should not walk. 5) Nothing should be done in the pricking (cut, suck, etc.). 6) After bandage removal the venom diffusion begins and from this moment the patient should be observed and treated with great care as if envenomation had happened in that moment. These simple measures are innocuous by themselves, will determine that the venom remains located where it does not damage, allow patient’s transportation to a medical care place without excessive hurry. The specific treatment will follow the usual criteria when removing the bandage.

Swaroop, S., Grab, B. Snakebite mortality in the world. Bull.World Health Org. 10: 76, 1954.

Sutherland, S.K., Coulter, A.R., Broad, A.J., Harris, R.D., Lovering, K.E., Roberts, I.D. A study of the major Australian snake venoms in the monkey (Macaca fascicularis) I: The movement of injected venom, methods which retard this movement, and the response to antivenoms. Pathology 13: 13, 1981.

Publication Dates

• Publication in this collection
  16 Apr 1999
• Date of issue
  1999