Prevention & Treatment of Stingray Injuries

The Bottom Line

Stingrays have long, thin, whip-like tails equipped with one to three barbed venomous spinal blades. Although they are generally shy, they may strike when unintentionally stepped on. Their venom causes intense pain, but the main risk of a stingray injury is the puncture wound. Hot water immersion and good wound care are central to managing stingray injuries.

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The Full Story

The stingray has a fierce reputation and is best known for its infamous tail – long, thin, and whip-like with one to three barbed venomous spinal blades. In Greek mythology, Odysseus was killed when his son Telegonus unintentionally stabbed him using a spear tipped with the spine of a stingray. In 2006, television personality and animal activist Steve Irwin, best known as The Crocodile Hunter, died after being pierced in his chest by a stingray. Stingrays pose a threat to fishermen and beachgoers. Every year, about 1,500-2,000 stingray injuries are reported in the US.

Contrary to its reputation, the stingray is a shy and even gentle creature that would rather swim away than strike. It reserves its stinger for its predators – sharks and other large carnivorous fish. It attacks people only when it feels directly threatened, often when it’s unintentionally stepped on.

Stingrays are flat and can vary in size from several inches to 6.5 ft. in length and weigh up to 800 lbs. Their wing-like fins create ripples in the water as they swim. There are 11 species of stingrays found in the coastal waters of the US. Their flat bodies and gray color allow them to be camouflaged on the sea floor, where they move slowly to forage for their prey (small fish and crustaceans like crabs and sea snails). Interestingly, a stingray cannot see its prey because its eyes are on the upper side of its body, while its mouth and nostrils are on the underside.

The dangerous part of a stingray is its infamous tail. The spinal blade is also known as the stinger or barb. This stinger is covered with rows of sharp spines made of cartilage and is strong enough to pierce through the skin of an attacker. Not only does the puncture itself cause injury and pain, but the stinger also releases a complex venom, which leads to intense pain at the puncture site. Uncommon effects of the venom include headaches, nausea and vomiting, fainting, low blood pressure, arrhythmias of the heart, and even seizures.

The most common sites of human envenomation are the legs and feet, which makes sense because the most common reason for envenomation is a swimmer unintentionally stepping on a stingray. The envenomation is often limited to severe pain that is relieved when the area is submerged in hot water. However, complications such as infection, serious bleeding, or physical trauma can occur. Part of the spine can also remain embedded in the tissue and require medical intervention to remove it. Death is extremely rare and results not from the venom but from the puncture wound itself if it is in the chest, abdomen, or neck. Death from serious infections like tetanus has also been reported.

Treatment of stingray injuries starts with first aid. Because the puncture is often deep and considered dirty, there is high risk of infection. It’s important to wash and disinfect the area immediately and obtain a tetanus vaccine or booster if needed. The wound should be inspected for any retained spines. The standard treatment for the pain is hot water immersion. Medical evaluation and treatment in a hospital is necessary if there are any retained spines in the wound, if the puncture is deep, or if it involves the chest, abdomen, or neck.

The best way to prevent being stung by a stingray is to avoid stepping on it when in the ocean by shuffling through the sand rather than lifting your feet and walking normally (commonly referred to as the “stingray shuffle”). This will warn a stingray of your approach, and it will likely swim away. A pole or stick can also be used ahead of your feet. Divers should be cautious and avoid swimming close to the sea floor. It is also important to know where stingrays are and never provoke them.

If you have a stingray injury, check the webPOISONCONTROL^® online tool for guidance or call Poison Control at 1-800-222-1222.

Serkalem Mekonnen, RN, BSN, MPH
Certified Specialist in Poison Information

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Prevention Tips

• To avoid unintentionally stepping on a stingray, shuffle or drag your feet along the sea floor rather than lifting your feet and walking normally (do the “stingray shuffle”).
• Divers should avoid swimming too close to the sea floor.
• Fishermen who unintentionally catch a stingray should not attempt to disentangle it from the net or fishing line.
• Never provoke a stingray.

This Really Happened

A 47-year-old Danish man was stung on his left ankle by a stingray while he was vacationing on the west coast of Africa. He was stung while walking in shallow waters about 10 ft. from the beach. He immediately experienced intense pain in his left ankle, and he limped to shore. A local sailor repeatedly attempted to suck out the venom with his mouth. He also brought an unknown plant root, chewed it, and applied it to the wound with a compression band.

The pain gradually lessened over the course of a few hours. The plant root and compression band were removed. On the fourth day following the injury, the man developed a high fever along with shivering. The wound had become infected. He was started on oral antibiotics, but the wound did not get better – it was red, swollen, and necrotic. He was switched to intravenous antibiotics and was eventually flown back to Denmark for continued medical treatment.

The wound was surgically cleaned. Samples of the tissue indicated a mixed infection with bacteria usually found in the human mouth. The wound slowly healed, and the man was able to return to work 3 months after the incident. (From Hønge et al.)

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For More Information

Stauffer K, Wallace RM, Galland GG, Marano N. Animal bites & stings (zoonotic exposures) [Internet]. Atlanta: Centers for Disease Control and Prevention; updated 2019 Jun 24 [cited 2020 Feb 28].

References

Charnigo A, Thiele G, Ondrus R. Stingray sting [Internet]. Treasure Island (FL): StatPearls Publishing; updated 2019 Jun 3 [cited 2020 Feb 28].

Hønge LB, Patsche CB, Jensen MM, et al. Case report: iatrogenic infection from traditional treatment of stingray envenomation. Am J Trop Med Hyg. 2018 Mar;98(3):929-32

Blohm E; Brush DE. Marine envenomations. In: Nelson LS, Howland MA, Lewin NA, Smith SW, Goldfrank LR, Hoffman RS, editors. Goldfrank’s toxicologic emergencies. New York: McGraw-Hill Education; 2019.

Stingrays [internet]. Washington: National Geographic; 2018 Sep 24 [cited 2020 Feb 28].

Poisoned?

Call


1-800-222-1222


or

HELP ME online

Prevention Tips

• To avoid unintentionally stepping on a stingray, shuffle or drag your feet along the sea floor rather than lifting your feet and walking normally (do the “stingray shuffle”).
• Divers should avoid swimming too close to the sea floor.
• Fishermen who unintentionally catch a stingray should not attempt to disentangle it from the net or fishing line.
• Never provoke a stingray.

This Really Happened

A 47-year-old Danish man was stung on his left ankle by a stingray while he was vacationing on the west coast of Africa. He was stung while walking in shallow waters about 10 ft. from the beach. He immediately experienced intense pain in his left ankle, and he limped to shore. A local sailor repeatedly attempted to suck out the venom with his mouth. He also brought an unknown plant root, chewed it, and applied it to the wound with a compression band.

The pain gradually lessened over the course of a few hours. The plant root and compression band were removed. On the fourth day following the injury, the man developed a high fever along with shivering. The wound had become infected. He was started on oral antibiotics, but the wound did not get better – it was red, swollen, and necrotic. He was switched to intravenous antibiotics and was eventually flown back to Denmark for continued medical treatment.

The wound was surgically cleaned. Samples of the tissue indicated a mixed infection with bacteria usually found in the human mouth. The wound slowly healed, and the man was able to return to work 3 months after the incident. (From Hønge et al.)

Stingray Information | Mount Sinai

A stingray is a sea animal with a whip-like tail. The tail has sharp spines that contain venom. This article describes the effects of a stingray sting. Stingrays are the most common group of fish that sting humans. Twenty-two species of stingrays are found in US coastal waters, 14 in the Atlantic and 8 in the Pacific.

This article is for information only. DO NOT use it to treat or manage an actual stingray sting. If you or someone you are with is stung, call your local emergency number (such as 911), or your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States.

Poisonous Ingredient

Stingray venom is toxic.

Where Found

Stingrays and related species that carry toxic venom live in oceans all over the world.

Symptoms

Below are symptoms of a stingray sting in different parts of the body.

AIRWAYS AND LUNGS

• Breathing difficulty

EARS, NOSE AND THROAT

• Salivating and drooling

HEART AND BLOOD

• No heartbeat
• Irregular heartbeat
• Low blood pressure
• Collapse (shock)

NERVOUS SYSTEM

• Fainting
• Body cramps and muscle twitching
• Headache
• Numbness and tingling
• Paralysis
• Weakness

SKIN

• Bleeding
• Discoloration and blistering, sometimes containing blood
• Pain and swelling of lymph nodes near the area of the sting
• Severe pain at site of sting
• Sweating
• Swelling, both at the sting site and throughout the body, especially if the sting is on the skin of the trunk

STOMACH AND INTESTINES

• Diarrhea
• Nausea and vomiting

Home Care

Seek medical help right away. Contact your local emergency services. Wash the area with salt water. Remove any debris, such as sand, from the wound site. Soak the wound in the hottest water the person can tolerate for 30 to 90 minutes.

Before Calling Emergency

Have this information ready:

• Person’s age, weight, and condition
• Type of sea animal
• Time of the sting
• Location of the sting

Poison Control

Your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. They will give you further instructions.

They will tell you if you should take the person to the hospital. They will also tell you how to do any first aid that can be given before you get to the hospital.

This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.

What to Expect at the Emergency Room

The health care provider will measure and monitor the person’s vital signs, including temperature, pulse, breathing rate, and blood pressure. The wound will be soaked in a cleaning solution and any remaining debris will be removed. Symptoms will be treated. Some or all of these procedures may be performed:

• Blood and urine tests
• Breathing support, including oxygen, tube through the mouth into the throat, and breathing machine (ventilator)
• ECG (electrocardiogram, or heart tracing)
• Intravenous fluids (IV, through a vein)
• Medicine called an antiserum to reverse the effect of the venom
• Medicine to treat symptoms
• X-rays

Outlook (Prognosis)

The outcome often depends on how much venom entered the body, the location of the sting, and how soon the person receives treatment. Numbness or tingling may last for several weeks after the sting. Deep stinger penetration may require surgery for removal. Skin breakdown from the venom is sometimes severe enough to require surgery.

A puncture in the person’s chest or abdomen may lead to death.

Auerbach PS, DiTullio AE. Envenomation by aquatic vertebrates. In: Auerbach PS, Cushing TA, Harris NS, eds. Auerbach’s Wilderness Medicine. 7th ed. Philadelphia, PA: Elsevier; 2017:chap 75.

Otten EJ. Venomous animal injuries. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 55.

Stone DB, Scordino DJ. Foreign body removal. In: Roberts JR, Custalow CB, Thomsen TW, eds. Roberts and Hedges’ Clinical Procedures in Emergency Medicine and Acute Care. 7th ed. Philadelphia, PA: Elsevier; 2019:chap 36.

Last reviewed on: 7/20/2021

Reviewed by: Jesse Borke, MD, CPE, FAAEM, FACEP, Attending Physician at Kaiser Permanente, Orange County, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

bites, first aid, symptoms and treatment

contents

Overview

Rays are flat, disc-shaped creatures with wing-like fins. River species can be salty or freshwater. They are most commonly associated with tropical oceanic climates, and their bites are the most common injury on the beach.

The hornet’s tail is long, thin and narrow, resembling a whip. At the end of the tail, one or more prickly spikes covered with a sheath. Each spike contains venom, and the stinger’s tail can deliver a strong, incredibly painful bite.

Stingrays are not usually dangerous – in fact they have a reputation for being gentle. They often burrow under sand in shallows and swim in open water. Stingrays usually only stink when unconscious swimmers swim in them.

You can avoid being stabbed most of the time. But if you feel a prick, there are a few things you can do right away to start relieving the pain.

First Aid for Knife Wounds

When stabbed, you will immediately feel severe pain at the wound site. It is necessary to start treating the wound immediately if it is superficial.

If a hedgehog has pierced your throat, neck, stomach, or chest, or completely pierced part of your body, do not attempt to remove it. Seek emergency medical attention immediately.

Otherwise, stay in the ocean and get the boat out if you can. Let the salt water cleanse the wound by applying pressure to slow bleeding and stimulate the release of toxin.

Try to remove any additional debris you may see when cutting or drilling while you are still in the water.

Pay attention to how you feel after being bitten. A life-threatening allergic reaction to the released poison is possible, so urgent medical attention is needed. Expect the area to swell.

Hot water kills the venom of the bite and may relieve the pain associated with the bite. Once you determine that you are not having an allergic reaction, you can try soaking the stinger in hot water (although some sources state there is no evidence that irrigation is effective).

The ideal soak temperature is between 110°C and 115°C. Heat the water every 43 minutes to keep it hot, and soak the wound for 46 to 10 minutes or as long as needed to soothe the pain. Warm water can also release a jelly-like poison.

After pain relief, apply antibiotic ointment or cream to the wound and cover with gauze.

What are the symptoms of a bite?

If you have been stung, you may notice the following symptoms:

• abdominal pain
• anxiety
• bleeding
• diarrhea
• dizziness
• severe pain at the wound site
• humor
• headache
• low blood pressure
• muscle cramps
• nausea
• necrosis (death) surrounding tissues
• pain in the extremities
• painful, swollen lymph nodes near the site
• discoloration of the skin
• swelling
• vomiting

The following symptoms may be signs of a systemic reaction or respiratory failure and require immediate medical attention:

• unconsciousness
• arrhythmia
• 7 seizures
• shortness of breath
• sweating

Possible cardiac arrest or shock state of the body after a bite. Several people died from stab wounds to the chest and abdomen.

If you have a stab wound and haven’t updated your tetanus shot, it’s time to get it back.

If you have had a sore for some time but are slowly healing, you have redness or extra swelling in the area, or the spot is starting to ooze pus, seek treatment immediately. The site may become infected and your doctor may prescribe antibiotics (orally or intravenously) to treat it.

Like stabbings

Since rays camouflage themselves under the sand when hunting, they can be hard to spot and easy to step on if you don’t know what to look for.

When threatened, the rye will defend itself with its tail, which can reach up to the head, leaving a wound or stab wound on our skin.

When you are hit by a whiptail, one or more of its spikes can pierce your skin. The sample around each spike then breaks down and releases the toxin into the wound and surrounding tissues.

Rays most often sting people on the legs, ankles and feet, but sometimes they can sting anywhere on the body.

To avoid being bitten by a stingray, shuffle your feet across the sand when walking in shallow water. This will alert you that you are coming. Another option is to throw grenades or small rocks into the water in front of you as you walk.

How are knife wounds treated?

If you are in a medical emergency, your doctor will carefully examine your wound. They have to remove all contamination of the match in the wound from the spikes or scabbard. They may take the x-ray pages to determine if all debris has been removed. The x-ray shows a fragment of the spine and scabbard.

You may be given a prescription or intravenous antibiotic, and stitches if the wound is large or deep. You can also get a tetanus shot.

In some cases, you may need postoperative surgery to remove dead tissue or heal a serious wound.

What is the probability of being stabbed?

In most people, stab wounds heal within a few weeks. Expect local numbness and tingling around the wound during the healing period.

The site of the bite, the amount of toxins in the tissue, the degree of tissue damage, and the speed of processing will affect healing time. If you need to undergo surgery after being bitten, your recovery will take longer.

Treatment after bites from animals and marine life costs 100-300 USD on trips. e.

May 10, 2023

Every year, hundreds of tourists seek medical assistance on insurance trips after unsuccessful encounters with sea urchins, jellyfish, poisonous fish, dangerous insects, as well as unfriendly monkeys, cats, dogs and other animals. Over the past year, more than 140 such appeals were recorded in Turkey alone.

“As a rule, such incidents do not require hospitalization, usually outpatient care is sufficient for effective treatment. Although there are, of course, complex cases when surgery or other manipulations are required in a hospital setting. The cost of medical services in different countries varies: in simple cases, it ranges from 100 to 300 USD. e. These expenses are covered under a standard travel policy,” says Olesya Sabanova, director of personal insurance underwriting at Soglasie.

However, the expert clarifies, standard insurance does not cover accidents at sea during diving or snorkeling – for such cases, an extended policy is required to include additional risks – “active recreation”, “diving”, etc. “If the vacationer is injured by corals (which, by the way, also belong to animals) during normal bathing – medical care will be provided under a standard policy. If a person was injured due to coral, jellyfish or any poisonous fish while scuba diving or snorkeling, then such cases will only be covered by extended insurance. Therefore, when applying for a travel policy, it is important to include current risks, depending on the activities planned for the trip,” explains Olesya Sabanova.

Among those who most often cause trouble for tourists, the expert named sea urchins, jellyfish, monkeys and street dogs. According to the expert, on some beaches where injuries due to sea urchins are common, the administration can provide vinegar to the victim as a first aid, as the vinegar dissolves the needles of these marine inhabitants stuck in the body.

“Rarely do vacationers seek medical help because of stingrays, poisonous fish, and cats,” continues Olesya Sabanova. – Even less often – because of the unfriendly behavior of horses, giraffes, as well as squirrels in parks, or forest urchins, which sometimes climb into urban areas. Shark attacks are among the rarest occurrences – such insurance events are rare and have only occurred a few times in recent years, ”the expert said.

When planning a vacation abroad, regardless of the chosen destination, it is important to have a first aid kit on hand, experts recommend. In it, in addition to the usual preparations and first aid for colds and diseases of the gastrointestinal tract, there should also be several types of adhesive plasters, sterile small-sized self-adhesive wipes, iodine or brilliant green for treating minor wounds and abrasions.

“In any case, in order to receive medical assistance, the insured should contact the service company whose contacts are indicated in the policy.