Clinical Severity in Scorpion Envenomation: Home Remedies, Delay to Medical Care, and Antivenom Dosing Strategies in an Emergency Department in Jalisco, Mexico

This group includes patients diagnosed with scorpion envenomation who were managed according to the traditional antivenom dosing strategy recommended by the Mexican national Clinical Practice Guidelines. These guidelines advise administering antivenom (faboterápico) to all patients with scorpion envenomation, independent of whether systemic symptoms are present, with dosing adjusted based on patient age and clinical severity.

Under this strategy, patients typically received one or more intravenous vials of antivenom as an initial dose, with additional doses administered at predefined intervals if symptoms persisted, in accordance with guideline-based algorithms. All treatments were provided as part of routine emergency care, and no interventions were assigned for research purposes. This group reflects standard-of-care antivenom use in Mexico during the study period.

This group includes patients diagnosed with scorpion envenomation who were managed using a reduced-dose antivenom strategy during routine emergency care. In this approach, antivenom (faboterápico) was administered primarily to patients with systemic manifestations of envenomation. The initial dose generally consisted of a single intravenous vial, with additional vials administered only if clinical symptoms persisted or progressed after reassessment.

Patients who did not receive antivenom because they presented without systemic symptoms were also included in this group. This management strategy differs from the Mexican national Clinical Practice Guidelines, which recommend antivenom administration to all patients with scorpion envenomation, regardless of the presence or absence of systemic symptoms. All treatment decisions were made by the treating physicians as part of standard clinical care, without protocol-mandated interventions.