Encounters with venomous sea-life

Isaac Fernandez, Genaro Valladolid, Joseph Varon, George Sternbach
Journal of Emergency Medicine 2011, 40 (1): 103-12

BACKGROUND: Sea-life with envenomation capabilities are quite abundant and diverse worldwide, being predominantly found in tropical waters. Most envenomations occur not as an attack, but as a result of self defense when the animal perceives danger; and often when locals or tourists are engaged in recreational activities. Most of these cases have only minor injuries, and few are fatal.

OBJECTIVES: To describe the impact, clinical features, and management of life-threatening marine envenomations.

DISCUSSION: Recognition of the injury and identification of the responsible animal is crucial for quick and successful management. Medical professionals should be cognizant of presenting symptoms such as respiratory distress, muscle paralysis, or cardiovascular decompensation. For these patients, antivenom should be given immediately if available, followed by pharmacological and physical therapy to relieve symptoms and pain. If any foreign bodies are left at the site of the injury, they must be removed. Tetanus prophylaxis should also be considered in case of puncture, and if signs of early infection are present, broad-spectrum antibiotics should be administered.

CONCLUSION: Management of envenomations from marine animals should be emphasized not only to health centers, but also to the general population, so that initial treatment can be started as soon as possible. Educational programs regarding risks and initial management for these incidents are also recommended to reduce the incidence and associated morbidity and mortality of the encounters.

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