diving and undersea medicine for the non-medical diver, the non-diving
physician and the specialist.
- Phylum Mollusca, Class
Conidae. These cones
possess a detachable, dart-like radicular tooth or muscular proboscis.
The venom is complex composed of two or more substances, one
(causing sustained contractions), the other inhibits nerve excitability.
wound with localized
ischemia (blanching), cyanosis (pale, bluish color), and edema
Severe pain, numbness, and tingling (paresthesias) of the mouth and
is noted. Sometimes there is respiratory distress and paralysis.
- Treatment: Immobilize the
limb, apply a
pressure dressing, administer CPR if needed. Cleanse the puncture site,
give analgesics and give tetanus prevention. Be prepared to support and
monitor respiratory function.
salivary glands of the blue-ringed
produce a venom, maculotoxin, that has effects similar to
then is followed by painless paralysis. The pattern begins with
sensations of the mouth, neck and head; followed by nausea, vomiting,
of breath and sometimes apnea ((lack of respirations).There can be
disturbances, impaired speech and swallowing, and generalized weakness
and paralysis. The duration is from 4 to 12 hours.
dressings, cleanse the bite, treat for tetanus and monitor the
These possess a serrated bony spine at the base of the dorsal surface
the tail. An integumentary sheath discharges venom when ruptured. Most
injuries occur when the ray is stepped on, the tail is thrust upward
forward and fired into the foot or leg. The venom is thermolabile
with heat) and induces severe vasoconstriction.
Intense pain is
at the site;
there is local ischemia (loss of blood supply), and edema. Edges are
may contain pieces of spine and secondary infection is common. Systemic
effects include salivation, sweating, vomiting, diarrhea, cramps,
(low blood pressure), and cardiovascular collapse.
spine. Immerse in hot (50 C) water until pain subsides. Give local or
pain relief. Cleanse, debride and suture the wound. Give tetanus
infection prophylaxis and monitor / support cardio-respiratory system
Salt Water Catfish
fins of the saltwater catfish have a complex toxin made up of
mix of high molecular weight proteins and low molecular weight
Like many marine toxins, this venom is believed to be denatured at
above 105 F.
intense pain that appears to be out of proportion for the
injury, systemic symptoms can occur but are rare. They include muscle
tremor, fatigue, syncope and even CV collapse. Treatment in the ER
of immersion of the body part in hot water at approx. 110 F,
(cleansing) of the wound completely and liberal irrigation with
water. Tetanus coverage is provided. It's a good idea to treat with
that cover Vibrio vulnificus, usually a 3rd gen cephalosporin.
allergic reactions can occur. If you are in a boat and
get to hot water, a good preparation to use is a paste of baking soda
meat tenderizer. This paste is also said to be effective for jelly fish
Links to Lionfish Injuries
Scorpaenidae. There are many species, including lionfish and
The venom is similar to stingray, is thermolabile and the stonefish is
the most toxic. An antivenin is available throughthe Australia
edema, cyanosis. Nausea, vomiting, hypotension, delirium and
- Phylum Chordata, Class
Squamata. The sea snake
is an inquisitive but usually nonaggresive air-breathing snake. The
is extremely toxic (2-10 times the cobra), and many bites are not
The venom is heat stable, is a nonenzymatic protein, and blocks
- Symptoms: The bite is noted
as there is an initial latent period varying from 10 minutes to 6-8
. There is the onset of malaise (bad feeling), anxiety and stiffness.
by aching and paralysis. Trismus (Jaw paralysis), ptosis (paralysis of
eyelids) are common. Ten percent of untreated cases are fatal.
- Treatment: Immobilize the
of the bite.
Hospitalize, obtain the antivenin and give CPR if needed. Try
land snake antivenom if specific not available. Hemodialysis can be
and respiratory support and control are often needed.