Stingray injury: Difference between revisions
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==Background== | ==Background== | ||
*Punctures skin to introduce venom | |||
*Generally local symptoms without systemic effects | |||
[[File:Dasyatis pastinaca01.jpg|thumb|Common stingray (''Dasyatis pastinaca'')]] | [[File:Dasyatis pastinaca01.jpg|thumb|Common stingray (''Dasyatis pastinaca'')]] | ||
[[File:Stringray's sting.jpg|thumb|A stingray's stinger (ruler in cm)]] | [[File:Stringray's sting.jpg|thumb|A stingray's stinger (ruler in cm)]] | ||
==Clinical Features== | ==Clinical Features== | ||
*Symptoms can vary by species | |||
*Local pain, irritation, erythema | |||
* | *Systemic symptoms can include vomiting, muscle cramps, hypotension, paralysis, cardiac arrest | ||
*Systemic symptoms can include | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{Marine envenomation DDX}} | {{Marine envenomation DDX}} | ||
== | ==Diagnosis== | ||
*Consider x-ray for retained foreign body (stinger) | *Clinical diagnosis | ||
*Consider x-ray to evaluate for retained foreign body (stinger) | |||
==Management== | ==Management== | ||
*Supportive | *Supportive care | ||
* | *Remove spines and stinger, if visible | ||
*'''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> | ||
*[[Tetanus prophylaxis]] | *[[Tetanus prophylaxis]] | ||
*Prophylactic [[antibiotics]] | *Prophylactic [[antibiotics]] are controversial - if used, give [[Ciprofloxacin]] to cover [[Vibrio vulnificus]] | ||
==Disposition== | ==Disposition== | ||
* | *Discharge | ||
==See Also== | ==See Also== | ||
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==External Links== | ==External Links== | ||
== | |||
==References== | |||
<references/> | <references/> | ||
[[Category:Tox]][[category:Environ]] | [[Category:Tox]] | ||
[[category:Environ]] | |||
Revision as of 05:45, 5 March 2016
Background
- Punctures skin to introduce venom
- Generally local symptoms without systemic effects
Clinical Features
- Symptoms can vary by species
- Local pain, irritation, erythema
- Systemic symptoms can include vomiting, muscle cramps, hypotension, 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
Diagnosis
- Clinical diagnosis
- Consider x-ray to evaluate for retained foreign body (stinger)
Management
- Supportive care
- Remove spines and stinger, if visible
- Immediately immerse wound in hot water (45°C for 30-90min) [1]
- Tetanus prophylaxis
- Prophylactic antibiotics are controversial - if used, give Ciprofloxacin to cover Vibrio vulnificus
Disposition
- Discharge
See Also
External Links
References
- ↑ 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.