• Anitha Abimannane, Ramachandran Rameshkumar, Ponnarmeni Satheesh, and Subramanian Mahadevan.
• Division of Pediatric Critical Care, Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.
• Indian Pediatr. 2018 Apr 15; 55 (4): 315-318.

ObjectiveTo study the effect of the second dose of scorpion antivenom in children with non-resolving or worsening scorpion sting envenomation.Methods72 children aged ≤12 years with scorpion sting envenomation grade 2 and above were enrolled. 61 received the first dose of three vials of antivenom at admission (group A). Children with persistent/worsening envenomation at 6 hours received the second dose (group B). The time required for resolution of autonomic symptoms, myocardial dysfunction, predictors of the second dose and side effects were studied.ResultsThe mean time taken for resolution of autonomic symptoms were similar in GroupA and B (4.1 vs. 5.3 hours, P=0.452), and of myocardial dysfunction was shorter in Group A (10.8 vs. 37.6 hours, P=0.019). On regression analysis, abnormal echocardiography at admission was found to be a significant predictor of the second dose (OR=27.6, 95% CI, 4.7-162.5; P=<0.001).ConclusionChildren with severe scorpion sting envenomation with abnormal echocardiography may require a higher dose of scorpion antivenom.

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