Marine Stings and Spikes

Treatment

Stings

• Jellyfish: Wash off the tentacles with sea water. Immerse the affected area in hot water (45^oC) Box jellyfish or Irukandji: Never use methylated spirit or alcohol. Domestic vinegars should be poured liberally over the tentacles to inactivate stinging cells as soon as possible. The tentacles may then be removed.
• Artificial respiration and cardiac massage may be required. Where antivenin is unavailable, pressure-immobilisation may be used on limbs after inactivation of stinging cells, while the patient is being transported to the nearest medical centre. Monitor vital signs and be prepared to initiate cardiopulmonary resuscitation if necessary in the case of box jellyfish stings or blue-ringed octopus bites.
• A blue-ringed octopus bite can cause paralysis; seek immediate medical help. The victim may need resuscitation. Even if your efforts seem futile, continue resuscitation until medical help arrives.

Spikes

• Stonefish: Do not attempt to restrict the movement of the injected toxin. Bathing or immersing the stung area in hot water may be effective in reducing the pain. Transport the patient to the nearest medical centre. Hospitalisation for intravenous narcotic analgesia, local anaesthetic infiltration or regional block may be required. Definitive management consists of administration of stonefish antivenin. Indications for antivenin include severe pain, systemic symptoms or signs of weakness, paralysis and injection of a large amount of venom.
• Stingrays: Although stingrays are venomous, the major clinical problem is often related to mechanical trauma from the sting. It may produce severe penetrating injuries and subsequent infection, including tetanus. Envenomation may result in increasing local pain that can spread to involve the entire limb, with swelling and a characteristic blueish/white appearance of the wound. Systemic symptoms are rare but may include nausea and vomiting, muscle cramps, diarrhoea, salivation, sweating, syncope, cardiac arrhythmias and convulsions.

Standard diving texts and first aid books will have more detailed information on dangerous marine creatures.

Scuba Diving

Diving is an enjoyable, but potentially dangerous activity. It requires knowledge of the potential risks and a cautious approach.

Before taking the plunge:

• Complete a diving medical with an approved doctor.
• Undertake a diving course with a recognised diving association.
• Inspect all rental equipment carefully.
• Always dive with an experienced companion.
• Avoid drinking alcohol the night before a dive.
• Do not dive with an upper respiratory infection or any other illness and avoid the use of decongestants.
• Refresh your knowledge on decompression sickness. Know where the nearest hyperbaric chamber is located.
• Certain anti-malaria medications, especially Mefloquine, are not recommended for use by scuba divers.
• Avoid flying within 24 hours of scuba diving.