Stingray injury: Difference between revisions

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==Management==
==Management==
[[File:Stingray injury.jpg|thumb|Treatment of stingray injury with hot water.]]
*'''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>
**Hot water is thought to denature the thermolabile venom
**Hot water is thought to denature the thermolabile venom

Revision as of 17:47, 11 March 2021

Background

  • Stinger punctures skin to introduce heat-labile venom
  • Generally causes local symptoms without systemic effects
  • Often occurs when swimmers accidentally step on stingray in shallow water. Can be avoided by shuffling feet along bottom.
Common stingray (Dasyatis pastinaca)
A stingray's stinger (ruler in cm)

Clinical Features

Differential Diagnosis

Marine toxins, envenomations, and bites

Evaluation

  • Clinical diagnosis
  • Consider x-ray to evaluate for retained foreign body (stinger)

Management

Treatment of stingray injury with hot water.
  • Immediately immerse wound in hot water (45°C for 30-90min) [1]
    • Hot water is thought to denature the thermolabile venom
  • Supportive care
  • Remove spines and stinger, if visible
  • XR for evaluation of foreign bodies
  • Tetanus prophylaxis
  • Prophylactic antibiotics are controversial - if used, give ciprofloxacin to cover Vibrio vulnificus

Disposition

  • Discharge

See Also

External Links

References

  1. 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.