Risk‐Stratified Observation After Asymptomatic Paediatric Scorpion Envenomation May Safely Reduce Emergency Department Stay
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2025
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| author | Inbal Kestenbom Shaked Bar‐Moshe Gidon Test Or Kaplan Tal Grupel Michael Shilo Natalya Bilenko Michael Friger Michal S. Maimon Dennis Scolnik |
| author_facet | Inbal Kestenbom Shaked Bar‐Moshe Gidon Test Or Kaplan Tal Grupel Michael Shilo Natalya Bilenko Michael Friger Michal S. Maimon Dennis Scolnik Inbal Kestenbom Shaked Bar‐Moshe Gidon Test Or Kaplan Tal Grupel Michael Shilo Natalya Bilenko Michael Friger Michal S. Maimon Dennis Scolnik |
| collection | Wiley Open Access |
| contents | Risk‐Stratified Observation After Asymptomatic Paediatric Scorpion Envenomation May Safely Reduce Emergency Department Stay Inbal Kestenbom Shaked Bar‐Moshe Gidon Test Or Kaplan Tal Grupel Michael Shilo Natalya Bilenko Michael Friger Michal S. Maimon Dennis Scolnik Acta Paediatrica ABSTRACT Aim Current emergency department (ED) protocols in prone regions recommend monitoring for at least 4–6 h after paediatric scorpion envenomation. Since only limited evidence supports these guidelines, particularly for asymptomatic children, we evaluated routine ED observation in these patients. Methods We conducted a retrospective cohort study of southern Israeli children presenting with scorpion envenomation over a 15‐month period using a validated envenomation severity score. The primary outcome was the development of delayed systemic symptoms requiring intervention. Children with Grade 1 scores (mild) were compared to those with Grade ≥ 2 scores (more severe). Results Of 287 patients, 238 (83%) presented with mild, and 49 (17%) with more severe envenomation. Less than 1% of mild patients developed delayed symptoms, all of which resolved with conservative management, and 99% were discharged. More severe patients were younger (median age 3.1 vs. 5.8 years), had a higher prevalence of allergy (31% vs. 13%), and 94% developed immediate symptoms requiring hospitalisation. Conclusion A risk‐stratified approach taking into consideration age, time since envenomation, history of allergies, and symptom severity could safely reduce ED observation time since children with mild scorpion envenomation symptoms had a low risk of developing significant delayed complications. 10.1111/apa.70310 http://onlinelibrary.wiley.com/termsAndConditions#vor |
| doi_str_mv | 10.1111/apa.70310 |
| format | Artículo Open Access |
| id | wiley_oa_10_1111_apa_70310 |
| institution | Wiley Open Access |
| license_str_mv | http://onlinelibrary.wiley.com/termsAndConditions#vor |
| publishDate | 2025 |
| publisher | Wiley |
| record_format | wiley_oa |
| spellingShingle | Risk‐Stratified Observation After Asymptomatic Paediatric Scorpion Envenomation May Safely Reduce Emergency Department Stay Inbal Kestenbom Shaked Bar‐Moshe Gidon Test Or Kaplan Tal Grupel Michael Shilo Natalya Bilenko Michael Friger Michal S. Maimon Dennis Scolnik Acta Paediatrica Risk‐Stratified Observation After Asymptomatic Paediatric Scorpion Envenomation May Safely Reduce Emergency Department Stay Inbal Kestenbom Shaked Bar‐Moshe Gidon Test Or Kaplan Tal Grupel Michael Shilo Natalya Bilenko Michael Friger Michal S. Maimon Dennis Scolnik Acta Paediatrica ABSTRACT Aim Current emergency department (ED) protocols in prone regions recommend monitoring for at least 4–6 h after paediatric scorpion envenomation. Since only limited evidence supports these guidelines, particularly for asymptomatic children, we evaluated routine ED observation in these patients. Methods We conducted a retrospective cohort study of southern Israeli children presenting with scorpion envenomation over a 15‐month period using a validated envenomation severity score. The primary outcome was the development of delayed systemic symptoms requiring intervention. Children with Grade 1 scores (mild) were compared to those with Grade ≥ 2 scores (more severe). Results Of 287 patients, 238 (83%) presented with mild, and 49 (17%) with more severe envenomation. Less than 1% of mild patients developed delayed symptoms, all of which resolved with conservative management, and 99% were discharged. More severe patients were younger (median age 3.1 vs. 5.8 years), had a higher prevalence of allergy (31% vs. 13%), and 94% developed immediate symptoms requiring hospitalisation. Conclusion A risk‐stratified approach taking into consideration age, time since envenomation, history of allergies, and symptom severity could safely reduce ED observation time since children with mild scorpion envenomation symptoms had a low risk of developing significant delayed complications. 10.1111/apa.70310 http://onlinelibrary.wiley.com/termsAndConditions#vor |
| title | Risk‐Stratified Observation After Asymptomatic Paediatric Scorpion Envenomation May Safely Reduce Emergency Department Stay |
| topic | Acta Paediatrica |
| url | https://onlinelibrary.wiley.com/doi/10.1111/apa.70310 |