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Chapter 29 — 11
hospital as soon as possible. Serious cases should be treated with sea snake
antivenom
(made
by CSL – Australia).
STONEFISH
This is the most venomous fish known. It is extremely well camouflaged and may not move
away when approached, as is implied by its name.
It is capable of inflicting severe stings by means of 13 poisonous spines along its back. The
spines are able to penetrate rubber soled
shoes or neoprene boots. At the base of
each spine is a venom sac which empties
its contents into the victim's wound.
Clinical Features
Envenomation results in severe
agonising
pain at the site
of puncture. Extreme
swelling
and
local paralysis
develops
rapidly. The venom can lead to
respiratory
distress
,
cardiac
disturbances
and syncope (
fainting
)
with a reduction in
blood pressure
.
Death is uncommon except in children or
the infirm.
Fig. 29.10
Stonefish
Treatment
Immersion of the stung area in hot water
about
45
°
C
(first tested by the attendant's hand,
to ensure against scalding) often gives significant pain relief and should be employed as soon
as possible as a first-aid measure. Elevating the wound may reduce swelling.
The severe pain of the sting can be relieved by the
injection of local anaesthetic
(with no
added vasoconstrictor agent such as adrenalin)
into the puncture sites.
This treatment may
need repeating several times before the pain stops recurring as the effects of the local
anaesthetic injection wear off. A physician may prefer to block the nerve supply to the region
with local anaesthetic as an alternative. Cleansing of the wound and antibacterial treatment is
required.
The
first-aid
basic life support
measures should be instituted where necessary (see Chapter
42).
Antivenom
from the Australian CSL Laboratories is available and its use may be
necessary in severe cases.