Background: Snakebite envenomation remains a significant public health concern in Asir Province of Saudi Arabia. Aim: To characterize snake species and the clinical presentation, outcome and management of snakebite cases admitted to 4 major hospitals in Asir Province, Saudi Arabia. Methods: This retrospective study reviewed medical records of paediatric and adult snakebite cases admitted to 4 regional hospitals in Saudi Arabia between January 2000 and December 2021 using search terms “snakebite”, “cobra”, “polyvalent antivenin”, “antivenom”, “compartment syndrome”, and “fasciotomy”. The data were analysed using R software version 4.2. Results: Sixty-nine patients were identified, of whom 30 (43.5%) were children aged 1000 U/L (8 patients; 11.6%), and acute kidney injury (4 patients; 5.8%), with 2 progressing to end-stage renal disease. Three patients (4.5%) died. A majority (94%) received initial 5-vial antivenom dose, with 39% requiring additional doses. Antivenom-related adverse reactions were mild and transient in 6 patients (9%). Blood products and antibiotics were used in 30% and 67% of cases, respectively. Anticholinesterase therapy was administered to 3 patients (4.3%). Conclusion: Snakebites pose a significant public health threat in Asir Province of Saudi Arabia. Antivenom, in addition to supportive care, remains the cornerstone of therapy, however, to optimize patient outcomes, our study highlights the need for a more comprehensive approach to management, as well as vigilant monitoring with prompt recognition and interventions.

Pesticide poisoning remains a major global health concern contributing to an estimated 371,594 deaths annually. Both accidental and deliberate pesticide exposure, particularly in developing countries, pose challenges to public health systems. In KSA, pesticide poisoning is prevalent, and insecticides such as carbamates and organophosphates are the primary culprits. Four cases of acute poisoning caused by the ingestion of contaminated shawarma sandwiches containing carbofuran and bifenthrin, a carbamate and pyrethroid mixture, respectively, are described. The affected individuals, all siblings, exhibited varying degrees of cholinergic symptoms, including muscle fasciculations, excessive secretions, and respiratory distress. Despite their severe symptoms, three patients had normal or low-normal acetylcholinesterase levels, probably because of individual variability, delayed testing, or improper sample handling. One patient exhibited diminished acetylcholinesterase activity, thus suggesting severe inhibition; pancreatitis was a further complication that contributed to delayed recovery. Early clinical management included atropine, pralidoxime, and botulinum antitoxin, because of initial suspicion for botulism. Toxicological analysis confirmed carbofuran poisoning, and food safety investigations identified improper pesticide use in food preparation areas. The reported cases underscore the importance of timely toxicological consultation, proper testing, and appropriate sample handling to guide treatment of pesticide-related poisoning. These findings highlight the crucial need for adherence to WHO regulations and monitoring of pesticide use, as well as strict food safety practices to prevent future outbreaks. The successful multidisciplinary approach to managing these cases demonstrates the critical role of coordinated efforts between clinical teams and public health authorities in addressing such public health threats.

Black widow spider (Latrodectus renivulatus) envenomation is a toxicological emergency affecting Middle Eastern countries. Young children may experience greater morbidity due to their small size relative to the amount of venom delivered. We describe four pediatric cases of severe black widow spider envenomation in Saudi Arabia. The neurological effects predominated, and all patients needed morphine for pain relief. All patients required admission to the pediatric intensive care unit (PICU). The durations of PICU stay and total hospital stay were 1–3 days and 2–5 days, respectively. Although Latrodectus antivenom is safe and effective, Latrodectus antivenom was unavailable, and no patients received antivenom. We believe that Latrodectus antivenom would rapidly relieve symptoms and shorten hospital stays.

Purpose: To evaluate disaster preparedness and surge capacity perception at the Armed Forces Hospital Southern Region (AFHSR), Kingdom of Saudi Arabia. Design/methodology/approach: A cross-sectional study was conducted using an instrument assessing perceived hospital preparedness and surge capacity within the AFHSR, which was developed based on a review of the literature. The items used in this instrument were adapted from the framework and thematic findings of Shabanikiya et al. (2016), covering eight domains: surge capacity, command and control, human resources, triage, communication, logistics and supply, safety and security and recognition and continuity. A total of 600 healthcare providers’ valid responses (response rate: 30.0%). Data were analyzed using descriptive statistics and correlation analysis. Findings: High awareness of disaster policies (89.5%) and prior real-world disaster exposure (58.5%) were reported. Strong perceived preparedness was observed in triage (1.12 ± 0.263) and safety and security (1.13 ± 0.266). Lower perceived performance was noted in human resources (1.22 ± 0.322) and communication training (1.19 ± 0.202). Awareness of the disaster plan significantly correlated with preparedness perceptions (r = 0.407**, p < 0.001), and awareness of the disaster policy significantly correlated with preparedness perceptions (r = 0.448**, p < 0.001). Research limitations/implications: The single-center design and moderate response rate may limit generalizability. Results underscore the need for targeted improvements in workforce planning and structured communication training to strengthen institutional resilience. Practical implications: Findings provide actionable guidance for hospital leadership to enhance surge capacity, optimize human resource strategies and reinforce communication frameworks. Social implications: Strengthened disaster preparedness improves patient safety, operational continuity and community confidence during public health emergencies and mass casualty incidents. Originality/value: This study delivers a structured, domain-based benchmarking of perceived preparedness in a major Saudi military hospital, contributing regional evidence to the limited literature on hospital surge capacity and disaster readiness.