Stingray injury: Difference between revisions
| Line 21: | Line 21: | ||
*'''Immediately immerse wound in hot water (45°C for 30-90min)''' <ref>Atkinson PRT. Is hot water immersion an effective treatment for marine envenomation? Emergency Medicine Journal. 2006;23(7):503–508. doi:10.1136/emj.2005.028456.</ref> | *'''Immediately immerse wound in hot water (45°C for 30-90min)''' <ref>Atkinson PRT. Is hot water immersion an effective treatment for marine envenomation? Emergency Medicine Journal. 2006;23(7):503–508. doi:10.1136/emj.2005.028456.</ref> | ||
*Clean area | *Clean area | ||
*Tetanus prophylaxis | *[[Tetanus prophylaxis]] | ||
*Prophylactic [[antibiotics]] = controversial | *Prophylactic [[antibiotics]] = controversial | ||
**[[Cipro]] for [[vibrio vulnificus]] coverage, if used | **[[Cipro]] for [[vibrio vulnificus]] coverage, if used | ||
Revision as of 00:57, 12 March 2015
Background
Mechanism
- Punctures skin to introduce venom
- Generally local symptoms without systemic effects
Clinical Features
Symptoms
- Vary with species
- Generally local pain
- Systemic symptoms can include vomiting, hypotension, muscle cramps, paralysis, cardiac arrest
Differential Diagnosis
Marine toxins, envenomations, and bites
- Toxins
- Ciguatera
- Scombroid
- Tetrodotoxin (e.g. pufferfish)
- Shellfish poisoning
- Amnesic shellfish poisoning
- Diarrheal shellfish poisoning
- Neurotoxic shellfish poisoning
- Paralytic shellfish poisoning
- Stingers
- Venomous fish
- Cone shell
- Lionfish
- Sea urchins
- Crown-of-Thorns Starfish
- Stonefish
- Other: Catfish, zebrafish, scorpion fish
- Nematocysts
- Coral reef
- Fire coral
- Jellyfish (Cnidaria)
- Portuguese man-of-war
- Sea anemones
- Seabather's eruption
- Phylum porifera (sponges)
- Bites
- Infections
Workup
- Consider x-ray for retained foreign body (stinger)
Management
- Supportive
- If visible remove spines and stinger
- Immediately immerse wound in hot water (45°C for 30-90min) [1]
- Clean area
- Tetanus prophylaxis
- Prophylactic antibiotics = controversial
- Cipro for vibrio vulnificus coverage, if used
Disposition
- Home
See Also
External Links
Sources
- ↑ Atkinson PRT. Is hot water immersion an effective treatment for marine envenomation? Emergency Medicine Journal. 2006;23(7):503–508. doi:10.1136/emj.2005.028456.