ED prov fellow MVH 12 Jan 2017 Blue bottle jellyfish Common Swarms in shallow water Immediate local effect Systemic sx uncommon Linear raised rash Wash off with saltwater Hot water immersion ID: 702519
Download Presentation The PPT/PDF document "Marine envenomation M Anto" is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.
Slide1
Marine envenomation
M
Anto
ED
prov
fellow MVH
12 Jan 2017Slide2Slide3Slide4Slide5
Blue bottle jellyfish
Common
Swarms in shallow water
Immediate local effect
Systemic
sx
uncommon
Linear raised rash
Wash off with saltwater
Hot water immersion
No PIB/vinegarSlide6
Box jellyfish
Can cause CVS collapse
Requires contact with several metres of tentacles, less in children
Vinegar then sticky tape to remove tentacles
Ice packs
Fluid
resus
, AV, inotropes or MgSlide7Slide8
Irukandji
Northern Australia
Minor local effects, severe generalised pain +
sympatheticomimetic
effects
May cause
pulm
oedema
Analgesia, ?MgSlide9Slide10Slide11
Venomous fish
Catfish, stonefish,
scorpionfish
Hot water immersion
Analgesia
LA or regional block (do not use hot water if anaesthetised)
AV stonefish IM
Treat infection
?Prophylactic
abxSlide12
Abx
Saltwater:
Vibrio - doxy
Freshwater, brackish water, mud:
Aeromonas
-
cipro
Vibrio - doxy
Fish tanks:
Mycobacterium
marinum
–
clarithyo
, doxy,
bactrim
Coral cuts:
Strep
pyogenes
- treat as per cellulitisSlide13Slide14
Stingrays
More related to trauma rather than venom
Venom causes pain and slowly progressive necrosis
Systemic
sx
uncommon
Hot water immersion
Debridement, primary delayed closure
?Prophylactic
abxSlide15Slide16
Sea urchin
Most non venomous
Sig pain if venom,
rx
with hot water immersion
XR/USS for retained spines
Can be observed for ongoing pain +/- surgical removalSlide17Slide18Slide19
Blue ringed octopus
Tetradotoxin
– Na channel blocker
Painless bite
Develop
paresthesia
nausea dizziness
Severe cases may progress to paralysis +
resp
failure
PIB recommendedSlide20Slide21
Cone snail
Inject venom via teeth
Causes local pain/swelling, weakness, incoordination, visual/speech disturbance, rarely progressing to paralysis +
resp
failure
PIB recommended
Manage airway + hypotensionSlide22
Summary
Symptomatic treatment
Hot water immersion
AV + vinegar for box jellyfish
Trauma/FB
PIB for blue ringed octopus + cone snail
Check and update ADT status
Abx
– saltwater
vs
freshwaterSlide23
References/resources
Managing injuries by venomous sea creatures in
Australia (Australian Prescriber)
Therapeutic guidelines (ETG)