Practice recommendations for scorpion envenomation (in the absence of antivenom)

These clinical practice recommendations provide focused guidance on the management of scorpion envenomation in the Western Cape, specifically in the context of the current unavailability of scorpion antivenom. This document is not intended as a comprehensive guideline on scorpionism, but rather addresses a critical evidence gap by offering practical, evidence-informed recommendations for frontline clinicians. The guidance reflects local epidemiology and resource constraints and was developed through a rapid evidence review and expert consensus process. Supportive care remains the cornerstone of management in the absence of antivenom.