Managing injuries by venomous sea creatures in Australia

Abstract

Marine injuries or stings are common, but the majority cause only minor effects and do not require medical intervention. Injuries from venomous marine creatures can be divided into jellyfish stings due to contact with nematocysts, and penetrating injuries from spiny fish, stingrays and sea urchins. Box jellyfish are the most dangerous and may cause severe and potentially life-threatening effects. First aid for jellyfish stings includes removal of the tentacles, and hot water immersion for bluebottles or vinegar for major box jellyfish. In addition to vinegar, major box jellyfish stings are treated with analgesia and local dressings. Early resuscitation is required in the rare severe cases. Irukandji syndrome causes severe generalised pain associated with autonomic effects with little local pain or reaction. Treatment is symptomatic but may require large amounts of analgesia. Spiny fish and stingrays cause a combination of traumatic injury and venom-mediated effects. First aid is hot water immersion and treatment includes analgesia, thorough wound cleaning and regular review for secondary infection. Stingray injuries can be associated with significant trauma and sometimes result in penetrating abdominal or thoracic injury.