Poisoning, Envenomation, and Trauma from Marine Creatures

R. ALLEN PERKINS, M.D., M.P.H., and SHANNON S. MORGAN, M.D., University of South Alabama College of Medicine, Mobile, Alabama

Am Fam Physician. 2004 Feb 15;69(4):885-890.

Patient Information Handout

In the course of their clinical work or during leisure activity, family physicians occasionally may encounter patients with injuries from marine creatures. Poisoning, envenomation, and direct trauma are all possible in the marine environment. Ciguatera poisoning can result from ingestion of predatory fish that have accumulated biotoxins. Symptoms can be gastrointestinal or neurologic, or mixed. Management is mostly symptomatic. Scombroid poisoning results from ingestion of fish in which histamine-like substances have developed because of improper refrigeration. Gastrointestinal and systemic symptoms occur. Treatment is based on antihistamines. Envenomations from jellyfish in U.S. waters and the Caribbean are painful but rarely deadly. Household vinegar deactivates the nematocysts, and manual removal of tentacles is important. Treatment is symptomatic. Heat immersion may help with the pain. Stingrays cause localized damage and a typically severe envenomation. The venom is deactivated by heat. The stingray spine, including the venom gland, typically is difficult to remove from the victim, and radiographs may be necessary to localize the spine or fragment. Surgical débridement occasionally is needed. Direct trauma can result from contact with marine creatures. Hemorrhage and tissue damage occasionally are severe. Infections with organisms unique to the marine environment are possible; antibiotic choices are based on location and type of injury. Shark attacks, although rare, require immediate attention.

The United States has more than 80,000 miles of coastline and a population showing increasing interest in scuba diving, snorkeling, surfing, and other water sports. Thus, more persons in this country will be coming in contact with marine life, and the potential for illness and injury from marine creatures is likely to increase. Family physicians may be called on to treat patients who have suffered trauma, envenomation, or poisoning from marine creatures. Marine medicine is still relatively new, so treatment recommendations for these conditions are largely based on case reports and expert opinion, with few randomized controlled studies available to guide management. Misdiagnosis is common, especially if the contact took place while the patient was traveling overseas or if the patient has been poisoned by improperly refrigerated seafood. This article describes ailments and injuries occurring as a consequence of direct contact with marine creatures, and discusses prevention and management options.

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TABLE 1

Fish Commonly Associated with Ciguatera Poisoning in the United States

TABLE 1

Fish Commonly Associated with Ciguatera Poisoning in the United States

Poisoning

CIGUATERA

Ciguatera poisoning is caused by ingestion of reef fish (Table 1)1 that have bioaccumulated sufficient amounts of the dinoflagellate Gambierdiscus toxicus through direct ingestion or ingestion of smaller reef fish. Although limited to tropical regions, the dinoflagellate is heat- and lipid-soluble and can survive transport to other areas. The toxin becomes more concentrated as it is passed up the food chain.

Each year, ciguatera poisoning accounts for several thousand illnesses in Puerto Rico, the U.S. Virgin Islands, Hawaii, and Florida. Patients exhibit primarily gastrointestinal or neurologic symptoms, or a mixed pattern of symptoms. A cold sensation reversal, in which the patient perceives cold temperatures as hot sensations, and vice versa, occurs in 80 percent of patients and is considered pathognomonic for ciguatera poison (Table 2).1,2

The attack rate may be as high as 80 to 90 percent in persons who ingest affected fish, depending on the size of the fish and the toxin load. Symptoms also are related to the number of exposures, with patients typically having more severe symptoms with subsequent exposures. No immunity is acquired through exposure. Symptoms begin one to six hours after ingestion, although a delay of 12 to 24 hours is possible. The duration of symptoms is typically seven to 14 days, with symptoms occasionally persisting for months to years.2

Currently, recommended treatment for ciguatera poisoning is supportive (Table 3).1 [Evidence level C, expert opinion/consensus guidelines] In most cases, provision of intravenous fluids to replace gastrointestinal losses is adequate. The use of atropine is indicated in patients with bradycardia, and temporary electrical pacing may be required in patients with refractory symptoms. Severe hypotension may require the use of pressors. Although mannitol (Osmitrol) often is cited as effective in reducing the duration of neurologic symptoms, the only double-blind trial failed to show any benefit.3 [Evidence level A, randomized controlled trial (RCT)]

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TABLE 2

Symptom Patterns Associated with Ciguatera Poisoning

TABLE 2

Symptom Patterns Associated with Ciguatera Poisoning

The ciguatera toxin is not deactivated by cooking, freezing, smoking, or salting. There are no outward signs of ciguatera—the affected fish look, taste, and smell normal. Although several commercial assays are available, they are not sensitive or specific enough to be relied on to prevent ciguatera poisoning. The only preventive measure is to avoid eating warm-water reef fish, especially those caught where ciguatera poisoning is known to occur, and large game fish from high in the food chain. If such fish are eaten, the risk of poisoning may be decreased by avoiding the consumption of internal organs and limiting the amount of initial ingestion. Although most cases of poisoning result from direct ingestion, in some cases ciguatera has been passed through sexual contact and breast milk.1

SCOMBROID

In the United States, scombroid poisoning is most common in Hawaii and California. Scombroid toxicity usually results from improper handling between the time the fish is caught and the time it is cooked. Improper preservation and refrigeration lead to production of histamine and histamine-like substances in the dark meat of certain fish such as tuna and mackerel. 4 The histamine reaction develops 20 to 30 minutes after ingestion. The symptoms—which include any or all of the following: flushing, nausea, vomiting, diarrhea, severe headache, palpitations, abdominal cramping, dizziness, dry mouth, urticaria, and conjunctival injection—typically last less than six to eight hours.4

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TABLE 3

Treatment of Ciguatera Poisoning

TABLE 3

Treatment of Ciguatera Poisoning

For treatment, antihistamines (50 mg of diphenhydramine [Benadryl] or its equivalent) are delivered intravenously or intramuscularly in severe cases, and orally in milder cases. In severe cases, 300 mg of cimetidine (Tagamet) may be added for more complete histamine-receptor blockade. If ingestion was recent, induced emesis may be considered.4 [Evidence level of evidence C, expert opinion/consensus guidelines] Patients should be instructed that they have not had an allergic reaction to fish, because the histamine is exogenous. Prevention is possible in regions where food storage and preparation are monitored through identification and removal of suspect fish.4

Envenomation

Many marine creatures are venomous, and beachgoers experience envenomation regularly. Jellyfish and related creatures (Cnidaria), sea urchins (Echinodermata), and stingrays (Chondrichthyes) are some of the more easily identified marine creatures involved with envenomations.

JELLYFISH

These invertebrates have stinging cells, called nematocysts, that continue to function when separated from the organism. For example, jellyfish nematocysts can sting if the tentacle is separated from the body and after the jellyfish is dead. The venom is antigenic and can cause a dermatonecrotic, hemolytic, cardiopathic, or neurotoxic reaction. The severity of the reaction depends on several variables, including the number of nematocysts that discharge, the toxicity of the coelenterate involved, and the unique antigenic response of the patient.

Although fatal anaphylaxis occurs occasionally in the United States and the Caribbean, the primary concern from these stings is pain, which is almost always self-limiting (Table 4).5,6 The symptoms may last two to three days. Certain Pacific jellyfish are much more dangerous, but they are limited to the waters around Australia.5

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TABLE 4

Symptoms of Cnidaria Envenomation in the United States and Caribbean

TABLE 4

Symptoms of Cnidaria Envenomation in the United States and Caribbean

Treatment of jellyfish stings in the United States and the Caribbean is concerned mostly with limiting pain and neurologic symptoms. The following general guideline can be applied. The patient should remove any visible tentacles carefully, using gloves or forceps if available to prevent further stings. If a towel is used for protection, any nematocysts adhering to the towel will discharge. Household vinegar can block discharge of the remaining nematocysts on the skin and should be applied liberally. If vinegar is not available, salt water can be used to wash off the nematocysts. Other solutions such as urine or fresh water and rubbing with sand should be avoided.5

If the patient presents to the physician’s office, household vinegar (5 percent acetic acid) should be applied for 30 minutes or until the pain subsides, followed by removal of the nematocysts, using gloves or forceps. Another method of removing the nematocysts is to apply shaving cream or a baking soda slurry to the area and then scrape off the nematocysts with a razor.5 [Evidence level B, double-blinded randomized trial]

Application of cold in the form of an ice pack or hot-water immersion have variously been shown to relieve pain, but because of the self-limited nature of the discomfort, it is hard to gauge an optimal therapy. Hot or cold therapy probably is acceptable until the patient is comfortable. Meat tenderizer has been found to be ineffective.6–8 [Reference 8—Evidence level A, RCT] Although not supported by evidence, local anesthetics, antihistamines, and steroids have been used to control prolonged symptoms. Antibiotics generally are not necessary.

ECHINODERMS

The echinoderm family includes sea urchins. Urchins have toxin-coated spines that break off, leaving calcareous material in the wound that potentially can cause infection. Symptoms include local pain, burning, and discoloration. The discoloration is thought to be a temporary tattooing of the skin resulting from dye in the spines. Absence of a spine in the skin is indicated if the discoloration spontaneously resolves within 48 hours.

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TABLE 5

Antibiotic Treatment of Infections Associated with Marine Trauma

TABLE 5

Antibiotic Treatment of Infections Associated with Marine Trauma

Theoretically, hot water disables the toxin, although there is no evidence that this treatment is effective in humans. If a spine is present and easily accessible, it should be removed with fingers or forceps. If it is close to a joint or a neurovascular structure, it should be removed surgically. If the patient is not symptomatic, retained pieces of spine likely will absorb into the skin.5

STINGRAYS

Although many fish are venomous, stingrays are the most clinically important, accounting for an estimated 1,500 (mostly minor) injuries in the United States annually. These creatures partially bury themselves in the sandy bottom of the ocean shallows, where water enthusiasts may accidentally step on them.

Stingrays have a spine at the base of their tail that contains a venom gland. The spine, including the venom gland, may be broken off in the attack and may remain in the wound. The venom has vasoconstrictive properties that can lead to cyanosis and necrosis, with poor wound healing and infection. Symptoms include immediate and intense pain, salivation, nausea, vomiting, diarrhea, muscle cramps, dyspnea, seizures, headaches, and cardiac arrhythmias. Fatalities are rare and usually a consequence of exsanguination at the scene or penetration of a vital organ.

Home care should include rinsing the area thoroughly with fresh water, if available (salt water may be used if necessary) and removing any foreign body. If the damage is minimal, the patient may soak the wound in warm water at home. The patient should watch for signs of infection and seek care for excessive bleeding, a retained foreign body, or infection.5,9 [Reference 9—Evidence level C, expert opinion/consensus guidelines] Medical treatment includes achieving hemostasis followed by submersion of the affected region in hot, but not scalding, water (42° to 45°C [108° to 113°F]) for 30 to 90 minutes or until the pain resolves. Typically, spines and stingers are radiopaque, so radiography or ultrasonography may be used to locate any remaining pieces.

The wound should be thoroughly cleansed, and delayed closure should be allowed. Tetanus immunization status should be reviewed and updated as appropriate. Surgical exploration may be necessary to remove residual foreign bodies. Prophylactic antibiotics (Table 5)5 are typically not necessary unless there is a residual foreign body or the patient is immunosuppressed.9

Trauma

Abrasions, bites, and lacerations are usually the result of a marine creature’s instinct to protect itself against a perceived danger. The most commonly involved creatures are octopi, sharks, moray eels, and barracuda. The trauma alone creates problems for patients, but the injury can be complicated by envenomation. It often is difficult to identify the marine creature involved in the attack. Treatment is symptomatic; local cleansing and topical dressing usually are adequate. If the wound becomes infected, antibiotics that cover common organisms should be selected (Table 5).5

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TABLE 6

Management of Marine Injuries: General Principles

TABLE 6

Management of Marine Injuries: General Principles

Although sharks receive much publicity, about 50 shark attacks occur worldwide annually, and these result in fewer than 10 deaths.10 Most of these attacks are in South African waters. Typically, these attacks involve tiger, great white, gray reef, and bull sharks. Attacks generally occur in shallow water within 100 feet of shore during the evening hours when sharks tend to feed. Common sense dictates avoiding areas of water where aggressive shark feeding has been noted.

Symptoms of shark attack range from abrasions to death from hemorrhage. Abrasions and lacerations occur when sharks brush against or aggressively investigate humans. Soft tissue and neurovascular damage, and fractures result from attacks. Most attacks result in minor injuries that require general wound care and, sometimes, simple suturing. The morbidity increases when wounds are greater than 20 cm or when more than one myofascial compartment is lost.

General principles of first aid in marine creature injuries are listed in Table 65,9 and should be followed in any and all marine injuries. Although it would seem self-evident, practices such as urinating on the injury, applying oil or gasoline to the injury, or applying any strong oxidizing agents, such as bases or acids, should be counseled against in patient education about self-care.

Stingray Injury Kit

Stingrays are common in coastal tropical and subtropical marine waters throughout the world, and also includes species found in warmer temperate oceans such as the Whip Tail stingray and those found in the deep ocean. Most stingrays have one or more barbed stings on the tail, which is used exclusively in self-defense.

Stingrays do not aggressively attack humans, though stings do normally occur if a ray is accidentally stepped on. To avoid stepping on a stingray in shallow water, the water should be waded through with a shuffle. Alternatively, before wading, stones can be thrown into the water to scare stingrays away.

Contact with the stinger causes local trauma (from the cut itself), pain, swelling, muscle cramps from the venom, and later may result in infection from bacteria. The injury is very painful, but seldom life-threatening unless the stinger pierces a vital area. The barb usually breaks off in the wound, and surgery may be required to remove the fragments.

Be sure to take along “The Solution” for safe and effective sting injury first aid when going to the beach, swimming, surfing, wind surfing or sport fishing..you’ll be glad you did…And don’t forget to check out our full line of marine sting first aid products…

The Stingray 1st aid kit comes with everything you need

to effectively treat your marine sting.

Kit Includes:

• Moist towelette for cleaning hands
• Latex-Free Gloves
• Gauze pad to help slow bleeding
• Sterile saline solution
• Forceps / Tweezers to remove spines
• Instant Heat pack, to alleviate pain
• Elastic wrap for holding the heat pack in place
• Ocean Care Solutions Triple antibiotic ointment
  
  to keep wound moist and prevent infection
• Adhesive bandage to cover wound

Bag is waterproof and resealable, allowing for use as an emergency ice pack

Can be easily stowed in a boat, kayak or vehicle

MADE IN AMERICA

Marine Bite Or Sting

You’re most likely to contact biting or stinging marine life while swimming or wading in saltwater. These include jellyfish and coral, as well as sculpins, stingrays, and many other kinds of fish. Most don’t attack people. But they may bite or sting if they are stepped on or touched. Even a dead jellyfish can release poison (venom) when handled. In North America, most marine animal bites or stings aren’t deadly. But they can be painful. They can be serious if the wound is deep, becomes infected, or causes an allergic reaction.

Your injury will be cleaned and examined. Bite or puncture wounds are often not closed with stitches. A jellyfish sting may be rinsed with sterile saline solution or vinegar. This prevents more toxins from being released. Applying heat to the area may also help accomplish this task. Any tentacles left in your skin will be removed. It’s better to remove them after inactivating them so they don’t release more toxin when handled. If stingray barbs are present, they need to be removed. If you have an allergic reaction that is severe, you may be given a steroid medicine to help control it. If you are in pain, medicine may be prescribed to make you more comfortable. Blood tests, ultrasound, wound culture, or X-rays may be done to check for other injuries or signs of infection. Treatment will depend on the location and severity of the wound.

Home care

Your healthcare provider may prescribe medicines to help ease pain and prevent infection. Follow your provider’s instructions for taking these medicines. If antibiotics have been prescribed, finish all of the medicine until it is gone, even if you feel better.

General care

• Wash your hands with soap and warm water before and after caring for the wound.

• Clean the wound with mild soap and water and pat dry. Do this as often as instructed by the provider.

• Watch for signs of infection, including fever, increasing pain, redness, or pus (discharge).

• If bleeding occurs, apply gentle, even pressure.

• Cover the wound with a new, clean bandage. Apply the bandage snugly, but not too tight. Keep the bandage clean and dry.

• Get plenty of rest and fluids.

• To prevent future stings, never handle any marine life. Even dead jellyfish on the beach can cause stings.  

Follow-up care

Follow up with your healthcare provider, or as advised.

When to get medical advice

Call your healthcare provider or get medical care right away if any of these occur:

• Swelling of the affected body part, hands, or face

• A feeling that there is something in the wound

• Fever of 100.4°F (38°C) or higher, or as directed by your provider

• Signs of infection, including increasing pain, increasing redness or swelling, or discharge from the wound

• Numbness or tingling in the area of the wound

• Pain that does not get better after taking medicine, or gets worse

• Your wound isn’t healing 

Call

911

Call 911 if any of these occur:

Treating a stingray sting – St Mark James Training

If an individual was accidentally stung by a stingray, he/she is likely to experience a very painful reaction.  Remember that there is limited information regarding the toxin from a stingray sting, only that it is protein-based and can be dangerous.

This is why it is vital to be prepared on what to do in case an individual sustained a stingray sting. Even though cases of stingray stings are uncommon, it is best that you are prepared.

What are the symptoms of stingray stings?

f bleeding is present, you have to control it using the basic steps such as applying direct pressure

• Bleeding
• Intense pain that can last up to two days
• Dizziness
• Swelling around the sting site
• Bluish or redness around the wound
• Muscle weakness or cramping
• Seizures
• Irregular pulse

The individual should be given immediate care in order to prevent these symptoms from worsening.

How to treat a stingray sting

Once an individual is suspected with a stingray sting, there are measures that you have to bear in mind.

• Always stay safe and do not panic. Remember that stingrays will deliver a sting as a way to scare us. In most cases, the sting is usually painful. The individual should move back to the safety of the shore by shuffling his/her feet to avoid being stung again.
• Call for emergency assistance as soon as possible. The individual with a stingray sting requires medical care. The stingray stings can cause intense pain and the individual will require medication to manage the pain. Before caring for the sting, always observe the universal safety measures and use proper gear or equipment if available.
• If bleeding is present, you have to control it using the basic steps such as applying direct pressure while awaiting the arrival of the emergency team.
• Clean the wound using fresh water and soap.
• If possible, removal all small parts or barbs of the stinger using pliers or tweezers. Only remove the stingers if the emergency team will be delayed. Take note that a long stinger can be considered as an impaled object. If there are stingers in the abdomen or chest, do not attempt to remove them. The removal of the stingers can lead to severe bleeding, thus it is vital to control the bleeding from any tissue damage.

If the emergency team will be delayed, some of the toxin can be neutralized by soaking the clean wound in fresh, warm water or applying towels soaked in warm water on the wound. Just be careful not to use water that is too hot since it might scald the individual.

Considerations to bear in mind

Stingrays spread out all over beaches every year but cases of stingray stings are uncommon. The usual method is to shuffle the feet to let the stingrays know that you are coming. On the other hand, you are more likely to stub your toe on a rock than stepping on a stingray.

Help I’ve Been Stung by A Stingray, What Next?

Stingrays have made a prominent presence at the ocean beaches this year. The numbers of stingrays in the shallow waters at the beaches have been extraordinary. Beach goers have been getting stung by the hundreds. Summer is over but it’s still hot, and people are still flooding to the beaches. Though, the lifeguard towers are now empty, and there’s no one left to help those who are getting stung.

We have teamed up with RayRX to find a solution to combating the stingray off season, and answering the question “I’ve been stung, now what do I do?”. We have created the perfect solution for lifeguard agencies and their “dirty bucket” epidemic.

After being stung by the venomous, sharp barb found on the tails of a stingray, each victim reacts differently. The barb carries a protein-based venom, that as it enters the body through the wound, causes short-term, but usually very intense pain. The pain caused by a sting is most extreme within the first 30 to 90 minutes, and the pain left untreated can last 6 hours or more, so quick action is vital. A Stingray’s venom is heat labile, meaning hot water not only makes the pain go away, but destroys the venom. Lifeguards must use 110°F (37°C) water to treat stingray injuries.

Getting to the hospital can be a challenge.  Many people have violent reactions to the sting of the stingray. Victims of a stingray stings may emerge from the water having trouble breathing, they may be bleeding profusely, or have intense cramping. The body may become riddled with tremors, as well, nausea and vomiting are common. The faster you can get treatment, the better off you will be. The longer you go without medical treatment, the greater problems can arise and the more excruciating the pain you will be. Crying and screaming tend to happen to even the most macho of men. And trying to drive yourself to the hospital is out of the question.

If you do get stung, your wound needs immediate attention. Every parent, every person, every lifeguard agency should carry the portable instant hot stingray kit available through the lifeguard store. These stingray kits are light weight, compact, and they produce instant hot water, to be used comfortably on the victim’s feet, no matter the size. 

On a typical summer day at the beach the lifeguards will traditionally reuse a white plastic 5-gallon bucket to soak victim’s feet in! The problem with this solution is that when reused, over and over, it is potentially putting the public in jeopardy. Stingray wounds bleed profusely, and quickly fill those buckets with blood. The odds are extremely high in contracting a blood born disease via one of those buckets. The CDC, (Center for Disease Control), specifically states; if blood borne pathogens such as AIDS, Hepatitis, or any other pathogens come in contact with another person’s blood, there is a 100% chance that they will contract the disease. The established process of decontamination by either physical or chemical means, to destroy blood borne pathogens on the surface of the white bucket, is not always followed, and lawsuits have been filed. That said to compliment the RayRX Stingray Kit, there is now the RayRX Stingray Bag. It is specially made for one person use, and has a poly/fabric boot that replaces that dirty plastic bucket. The stingray bag can also be taken home by the victim, to continue treatment.

The Stingray Bag also solves the next issue lifeguards are plagued with, the need to continually rotate hot water every 10 minutes, to keep the temperature where it needs to be. The single use Stingray bags are self-heating, and light enough to be carried in a towel bag. The Stingray Bags military technology can give you hot water anywhere. By using this system, it completely eliminates the possibility of blood borne pathogen transmission from one victim to another.

This small compact stingray kit is great for parents, kids, and surfers. It can even be stored in your car.

True watermen of the past were known to keep a small propane stove, a pan, a 5-gallon plastic bucket, matches and a bottle or two of propane in their cars for this emergency, but the instant hot all in one RayRX Stingray Kit sold at our lifeguard store will save yourself, your kids, or a friend much undue pain and discomfort.

The urine cure for stingray attack

Matt: Maybe you can help me regain my $5. Say you’re on the coast of Baja, there’s no fresh water or medical services around, and you’re stung by a stingray. I’ve been told the best thing to do in this situation is to urinate on the wound, although the Poison Control Center strongly disagrees. This information came from a college professor of biology. — Mike English, San Marcos

It’s a well-known folk remedy, though I couldn’t find any folk who’d actually tried it or even knew anyone who had. Believers state that stingray venom is acid, urine is alkaline, so peeing into the wound neutralizes the poison. In fact the venom is only mildly acidic (pH 6.6; 7 is neutral). Some say you’re safer from infection if you flush the wound with your own urine than with potentially contaminated seawater. Most physicians would still recommend the seawater. I hope that fiver wasn’t on the professor.

The tail barb on a ray is viciously serrated and covered with a fleshy sheath. When an unalert beachgoer steps on a dozing ray, it whips its tail up and jams the barb into the bather’s foot or ankle or gashes his flesh. The sheath tears off the barb, and the venom is released. For the next 30 to 90 minutes, our hapless surf bunny writhes in excruciating pain. Assuming the victim will let anyone near his swollen, throbbing leg, the recommended first aid is to flush the area (yes, even with seawater) to remove as much venom as possible, then remove as much of the fleshy sheath as can be seen in the wound. (The biggest danger from stingray stings is infection, usually a result of bits of the sheath remaining in the wound.) Then stick the wound in water as hot as the victim can tolerate or apply hot compresses. That eases some of the pain and may help neutralize the venom, which is chemically unstable and loses its toxicity when heated. Stingrays use their barbs defensively against fish, so there’s not enough venom delivered in each sting to seriously affect the average healthy adult human (though beware of an allergic reaction to the venom’s protein and of stings to the upper body, near the heart, which are more dangerous than wounds to extremities). Most people stung by rays ride out the pain without consulting a physician and without lasting injury. But a quick check by a doctor is the safest course, especially if you haven’t had a tetanus shot in more than ten years. And increase your chances of avoiding the whole painful thing during San Diego’s ray days (July and August) by scuffing your feet through the sand when walking in shallow water. Then you’ll only have to worry about the broken glass and medical waste.

Question: How to treat a stingray bite? – Health

Contents of the article:

Stingray stingrays

Video taken from the channel: NatuRArrium Diary: Notes on Nature

Stingray treatment Motoro

Video taken from the channel: akvamir78rus

Stingray treatment stopped eating stingray!

Video taken from the channel: Vasily Bely

Stingrays off the Odessa coast.Should you be afraid of them?

Video taken from the channel: News Channel 7 Odessa

A blow of a house stingray with a poisonous thorn. Is it dangerous to keep stingrays at home?

Video taken from the channel: Alexander Boyarchanin.

Black Sea stingray stingray. First aid to the victim

Show Description

This video focuses on the common stingray (lat. Dasyatis pastinaca), known as the sea cat. It is this fish that periodically terrifies vacationers on the Black Sea coast.And it is not surprising, because on the tail of the stingray there is a poisonous thorn, which this fish skillfully uses in self-defense.
We will tell you:
• what is the danger of stingrays and sea cat in particular;
• what is the threat of a stingray prick to a person ;.
• what to do (first aid) if a person is injured by the stingray ;.
• How to avoid troubles associated with meeting a sea cat ..
Enjoy your viewing, everyone!
ATTENTION! In the video there is a scene where I touch the stingray with my hands.They managed to catch him by driving him to the shore and carefully picking him up, after which the slope was placed in a pit with sea water during the shooting. However, this behavior is risky, since not only carrying a stingray on your hands (this is to the question of whether a stingray can let a person get close enough and even be in your hands), but also light touching it can lead to the defensive behavior of a sea cat and end in failure … Everyone who wants to play with the stingray should understand this, and then see for yourself: we warned you 😉

Video taken from the channel: Maxim Chechetov

Crimea.Stingray stingray prick. TIN !!!

Video taken from the channel: Oleg Ageev

90,000 Snake bites. First aid

End of spring, summer, beginning of autumn – this is the period when many people go to the forest for mushrooms and berries. Sometimes this is fraught with the danger of being bitten by poisonous animals. According to the WHO (World Health Organization), more than 10 million people are registered annually in the world who are bitten by poisonous animals, of which about 50 thousand die.The toxic danger for children is especially great.

How to avoid a snake bite in the forest

First of all, when going to the forest, it is best to wear rubber boots and tight trousers. If you decide to sit down and rest, use a stick to check for a snake nearby. If you suddenly notice a crawling snake, freeze, let it leave. If the snake is in a threatening pose, step back slowly. Avoid sudden, snake-frightening movements! You cannot, defending yourself, put your hands forward, turn your back to the snake.Do not run away from the snake you meet – you can step on another unnoticed. Remain calm in decisions, actions, gestures. Remember, a snake that you do not see is dangerous, a detected snake does not pose a threat.

The clinical picture of snake venom poisoning depends on the amount of poison, the site of the bite (bites to the head, neck and bites with damage to large vessels are very dangerous, when the poison enters the general bloodstream and severe poisoning quickly develops), the age of the victim (in children, the clinic of poisoning is more violent and bright), seasons (severe cases are most often noted with the onset of heat).The higher the air temperature, the faster intoxication develops.

A viper bite immediately causes severe, progressive pain. At the site of the lesion, two scarlet dots are usually noticeable – traces of poisonous teeth. Soon, pinpoint or spotty hemorrhages appear at the site of the bite, rapidly progressive edema of the affected limb. There is increased bleeding in the area of ​​the bite. The skin becomes bluish or slate gray. General symptoms of poisoning occur, as a rule, after 15 to 20 minutes.These are general weakness, dizziness, lethargy, drowsiness, nausea, sometimes vomiting, shortness of breath, increased heart rate. Fatalities are very rare.

First Aid:

In connection with the rapid development of the toxic effect, measures of first self-help and mutual assistance are of great importance. If you are bitten by a snake, you must immediately start vigorously sucking the venom out of the wound with your mouth. To do this, you need to squeeze the tissue surrounding the wound with your teeth, squeezing out and simultaneously sucking it out, and quickly spit out the extracted fluid.Continue this procedure for 15 to 20 minutes. Do not forget: you can not suck the poison to someone who has cracks, sores or wounds on the lips and in the mouth. It has been found that suction removes from 28% to 46% of all poison introduced into the body. However, you should be aware that this measure is only effective in the first 20-30 minutes! Then you should lubricate the bite site with an antiseptic, apply an aseptic bandage.

The victim needs complete rest. He is seated or laid down, the affected part of the body is immobilized, since the spread of poison from the site of the bite increases during movement, and a splint is applied to it, as in a fracture.For this, you can use any available items. You can do without a splint by bandaging the arm bent at the elbow to the body, and the injured leg to the healthy one. Give the victim a plentiful drink, strong tea is better. To slow down the absorption of the poison, cold is shown at the site of the bite. After providing first aid, the victim must be immediately taken to the nearest medical institution, and transported in the supine position.

Remember! First aid should be provided in a timely manner.This will ensure a quick recovery and recovery of the victim’s ability to work!

Doctor-toxicologist (head of the toxicology department)

A. N. Bogdan

How to treat stingray bites – First Aid

If you manage to surprise a stingray and get a bite, you will most likely have a very painful reaction. It will hurt, but chances are it won’t kill you unless you get stung multiple times or in a vital area.

Little is known about the toxin in the stingray bite, other than that it is protein-based and can be dangerous. Australian conservationist Steve Irwin was killed in 2006 when a stingray hit him multiple times, striking him in the chest. It is widely accepted that his physical injuries, and not any kind of poison, led to his death.

Incidence of stingray bites

There are approximately 1,500 stingray bites in the United States each year. Most stingray bites occur on warm beaches in states such as Florida or California.Conventional wisdom says to shuffle your legs so the stingrays know you are walking. Of course, you are more likely to stomp your foot on a rock than step on a slope.

Stingray Bite Symptoms

• severe pain (may last up to two days)
• bleeding
• swelling around the wound
• redness or blue discoloration around the wound
• dizziness
• muscle cramps or weakness
• seizures
• irregular heart rate
• low blood pressure

Since most of the bites are from stingrays stepped on by beach goers, most injuries are to the legs and feet.Fishermen are an exception: they are stung on their hands more often than anywhere else. Regardless of the location of the bite, the treatment should be the same. If you suspect a stingray bite, follow these steps:

measures

1. Stay Safe, Don’t Panic The sting of the stingrays to scare us away. The bite is painful, but usually not very harmful. Patients should return to shore safety by shuffling their legs (so they don’t get stung again).
2. Call 911. A patient with a stingray bite will need medical attention.Stingray bites are very painful, and patients, at a minimum, need treatment to control the pain. Follow universal precautions and wear personal protective equipment, if you have one.
3. Control any bleeding and follow basic first aid steps while waiting for the ambulance to arrive.

1. Clean the wound with soap and clean clean water. If not, at least rinse the wound with copious amounts of seawater.
2. Use tweezers or pliers to remove small parts or notches from the tip. Only remove the sting if a medical emergency is significantly delayed. A long sting will be considered a pierced object. DO NOT REMOVE COMPLAINTS FROM CHEST OR ANIMALS!
   1. Removing the sting may result in severe bleeding. Remember to control bleeding from any tissue damage.
3. If medical attention is delayed significantly, some toxins can be neutralized by immersing the cleansed wound in fresh hot water (110 to 113 degrees Fahrenheit) or by placing towels soaked in hot water over the wound.Be careful that the water is not too hot to burn the victim.

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Was this page helpful? Thanks for your feedback! What are your problems? Article Sources

• Clark AT, Clark RF, Cantrell Florida. A retrospective review of the presentation and treatment of stingray bites in a poison control system. Am J Ther, 5 February 2016.Epub ahead of print
• Clarke R.F., Girard R.H., Rao D, Lee B.T., Davis D.P. Envenomation Stingray: A Retrospective Review of Clinical Presentations and Treatment in 119 Cases. J Emerg Med, 2007 Jul; 33 (1): 33-7. Epub 2007 May 30.
• Meyer PK. Stingray injuries. Wilderness Environ Med, 1997 Feb; 8 (1): 24-8. Overview.

Allergen i71 – mosquito, IgE (ImmunoCAP)

Quantification of allergen-specific immunoglobulins of class E to mosquito allergens.

Russian synonyms

Specific class E immunoglobulin for mosquito.

Synonyms English

i71 – Aedes communis, Mosquito.

Research method

Immunofluorescence on solid phase (ImmunoCAP).

Units

IU / L (international unit per liter).

Which biomaterial can be used for research?

Venous blood.

How to properly prepare for the study?

• Do not smoke within 30 minutes prior to examination.

General information about the study

Allergen is a substance that causes an allergic reaction. There are a huge number of substances of natural or artificial origin, each of which can become an allergen for humans.

Allergies resulting from stinging, insect bites, contact with them, involuntary inhalation of their particles or waste products is called insect allergy. Most of the allergic reactions are caused by stings of bees, wasps, mosquitoes, midges.Mosquito allergy is called kulicidosis.

Antigens cause the development of sensitivity when they enter the body in different ways: when bitten by blood-sucking representatives of the order of Diptera (mosquitoes, mosquitoes), inhalation of aeroallergens and in direct contact – in any case, when in contact with their saliva. Allergic reactions that occur after a mosquito bite are caused by sensitization to a protein from the mosquito’s saliva. Mosquito saliva is toxic to humans, and when mosquitoes inject their venom, inflammation develops in the body.In this case, it is not so much the amount of poison received during the bite that matters, but the potential ability of the antigen to cause the body’s immune response. Hypersensitivity reactions to bites range from local skin reactions such as urticarial eruptions, papules, localized itching and pain, to systemic manifestations such as fever, urticaria, laryngeal edema, bronchospasm, and anaphylactic shock.

The prevalence of allergy to mosquito bites in Russia ranges from 5-20%.It is assumed that the human body can withstand about 400 mosquito bites without developing a toxic reaction. But for those with a predisposition to allergies, one bite is enough to develop an allergic reaction to mosquito saliva. Especially often, the immune response to mosquito bites is formed in children.

Sensitization to mosquito allergens is confirmed by the determination of a high titer of specific IgE in blood serum. Based on the results of the study, patients can be selected for specific immunotherapy with wasp venom.

Quantification of specific IgE antibodies allows you to assess the relationship between antibody levels and clinical manifestations of allergy. Low values ​​of this indicator indicate a low probability of an allergic disease, while a high level has a high correlation with clinical manifestations of the disease. If high levels of specific IgE are detected, it is possible to predict the development of allergies in the future and a more vivid manifestation of its symptoms. However, the concentration of IgE in the blood is unstable.It changes with the development of the disease, with the amount of the received dose of allergens, as well as during treatment. It is recommended to repeat the study when symptoms change and when the ongoing treatment is monitored. The need to re-examine should be consulted with the attending physician.

The purpose of this study is the determination of specific IgE to mosquitoes by the ImmunoCAP method. ImmunoCAP is characterized by high accuracy and specificity: even very low concentrations of IgE antibodies are detected in a small amount of blood.The study is revolutionary and is based on the immunofluorescence method, which allows increasing the sensitivity several times compared to other assays. The World Health Organization and the World Organization of Allergists recognize ImmunoCAP diagnostics as the “gold standard” as it has been proven to be accurate and consistent in independent studies. Thus, the detection of specific IgE using this technique brings allergy diagnostics to a qualitatively new level.

What is the research used for?

• For the diagnosis of allergic diseases associated with sensitization to mosquito bites;
• for screening for insect bite sensitization.

When is the study scheduled?

• In case of allergy symptoms (including the appearance of urticarial and papular skin rash, edema of the mucous membranes, rhinitis, lacrimation, bronchospasm, an attack of bronchial asthma, etc.) that occur immediately after a mosquito bite or after a short time.

What do the results mean?

Reference values: 0 – 0.34 IU / l.

Reasons for an increase in the level of specific IgE:

• Hypersensitivity to mosquito allergens; mosquito sensitization with a high risk of developing an allergic reaction after being bitten.

Reasons for a decrease in the level of specific IgE

• absence of IgE sensitization to this allergen;
• limiting or excluding contact with an allergen;
• drug treatment.

How to treat a stingray bite

Since the beginning of spring, 2 residents of Chuvashia were hospitalized due to snake bites

In the spring of 2018, 2 people who suffered from a snakebite applied to the acute poisoning department of the Emergency Hospital of the Ministry of Health of Chuvashia.

According to the head of the department, chief freelance specialist toxicologist of the Ministry of Health of Chuvashia Alexandra Prokhorovskaya , patients were admitted within the last two weeks.

– According to the patients, while the weather was fine, they went to the forest, where they were bitten by snakes. Fortunately, none of the bites were fatal. The patient who was admitted to the acute poisoning unit of the Emergency Hospital last week has already been discharged home. A young man from the Urmarsky region is currently completing his treatment. The general condition of the patient is satisfactory. He received qualified medical assistance. The prognosis is favorable, however, he underwent long-term treatment and still needs outpatient rehabilitation.For comparison, in 2017, during the summer season in Chuvashia, 25 people suffered from snake bites, – Alexandra Georgievna noted .

Fortunately, no children have been harmed by snakebites this season. If necessary, children under 15 years of age are hospitalized at the City Children’s Clinical Hospital of the Ministry of Health of the Czech Republic

Only one type of poisonous snake is widespread in Chuvashia – vipers. It should be remembered that poisonous snakes are not aggressive, they do not attack first, therefore, if this happens, it means that they acted for self-defense.A person needs to learn that, having seen a reptile, it is better to bypass it and in no case touch it. It is necessary to remain vigilant throughout the summer period, including September and even October, when the activity of snakes and the pronounced toxicity of their venom can also persist. Snake bites usually occur imperceptibly, sensations in the form of an injection, followed by a toxic-allergic reaction up to the development of anaphylactic shock with damage to the bitten limb in the form of edema with subcutaneous hemorrhages, which are caused by the toxic effect of snake venom on the blood and blood vessels.

The Republican Center for Medical Prevention, Physical Therapy and Sports Medicine prepared a memo for the population “Prevention of snake bites” . The memo contains information on how to distinguish a venomous snake from a non-venomous one, lists the main signs of poisoning and how to provide first aid. It is especially noted that the victim of a poisonous snake bite must necessarily seek medical help. In all cases of the appearance of symptoms of poisoning with snake venom, hospitalization is necessary for subsequent treatment.

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