Spines break off and release neurotoxin, causing immediate burning pain, then edema and erythema Scallops, oysters, slugs, squid, cone shells, some octopus Portuguese man-of-war, box jellyfish, corals Verapamil is not recommended.Ī specific ‘sea wasp’ antivenom is manufactured by the Commonwealth Serum Laboratories in Australia for Chironex fleckeri stings. 127ĬPR on the beach has proved life-saving in several patients who collapsed, cyanosed and pulseless. Pressure immobilization with a crepe bandage may increase the amount of venom injected and is not recommended. However, 5–15% lignocaine hydrochloride prevented discharge and relieved the pain of Chiropsalmus quadrumanus and Chrysaora quinquecirrha stings, in proportion to the concentration applied. In vitro, several popular remedies, such as alcohol (in sun lotion), ammonia, acetic acid and meat tenderizer, caused massive discharge of Chrysaora quinquecirrha and Physalia physalis tentacles. For Chrysaora stings, baking soda and water (50% w/v) is used. For Chironex and other cubozoans, including Irukandji, commercial vinegar or 3–10% aqueous acetic acid inhibits further nematocysts discharge but is not recommended for stings by Physalia or Stomolophus. Undischarged nematocysts in adherent tentacles should be inhibited. The victim is taken out of the water, adherent tentacles are washed off with sea water or removed by shaving the skin and hot water is applied to relieve pain (see above, as for fish stings). Warrell, in Manson's Tropical Infectious Diseases (Twenty-third Edition), 2014 Treatment.Īppropriate first aid is urgent as patients may die within minutes of the sting by box-jellyfish. Star of Bethlehem, Indian tobacco ( Lobelia inflata) (Jerusalem cherry or ornamental pepper, black nightshade) Mushrooms (especially Amanita muscaria, Pantherina, Psilocybe, Panaeolus, and Copelandia spp.) Morning glory ( Ipomoea purpurea, Rivea corymbosa) Copperhead, cottonmouth, some rattlesnake venom
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