MEDI7305 Lecture Notes - Lecture 8: Tetanus, Local Anesthesia, Hydrophiinae
M3c - Spider, Bug and Marine Creature Bites & Stings
Marine creature bites and stings
Box jellyfish Two species
Chironex fleckeri - major box jellyfish
Chiropsalmus
67 recorded deaths in Aus (within first 5min of sting)
Location
Chironex fleckeri - it extends along northern coastline of Aus from Gladstone
(east coast) to Exmouth (west coast)
Chiropsalmus - it is restricted to Cairns region
Northern Aus waters all year round but mostly between Oct and May
Close to shoreline in shallow waters, tidal creeks and around boat ramps
(almost invisible in water)
Characteristics
Bell (up to 35cm diameter) + 3m long tentacles (up to 60 tentacles each)
Tentacles contain millions of stinging cells (nematocysts) that inject venom
upon skin contact
Symptoms/ signs
Cardiotoxic, neurotoxic and highly dermatonecrotic
Immediate excruciating pain causing irrational behaviour
White welts appear frosted & become red whip-like -> permanent scarring
can occur
Large dose of venom (especially in small children) can cause rapid cardiorespiratory
arrest and death within few min
Management
Early CPR > anti-venom for greater survival benefit in cardiac arrest
Keep patient calm
Avoid - rubbing skin with towel, washing with fresh water, applying PBI
Flood stung skin with vinegar for 30secs -> vinegar permanently inactivates
nematocysts + tentacles can be removed without risking further envenomation
Apply - ice packs, IV opiates (pain), anti-histamines, BP control
Anti-venom
o1 ampoule - severe pain unresponsive to IV opiates
o3 ampoules diluted in normal saline - collapse, hypotension,
significant cardiac arrhythmia (repeat if necessary)
o6 ampoules undiluted via IV access - cardiac arrest
Irukandji
syndrome
Several species of jellyfish causing Irukandji syndrome, usually Carukia barnesi
2 recorded deaths in Aus
Location
Northern Aus between Tropics of Cancer & Capricorn - East coast (occurs as
far south as Bundaberg) & West coast (significant issue for pearl divers based in Broome)
Northern Aus waters all year round, but mostly between Oct and May
Found offshore, at reefs and around islands (almost invisible in water)
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Document Summary
M3c - spider, bug and marine creature bites & stings. 67 recorded deaths in aus (within first 5min of sting) Chironex fleckeri - it extends along northern coastline of aus from gladstone (east coast) to exmouth (west coast) Chiropsalmus - it is restricted to cairns region. Northern aus waters all year round but mostly between oct and may. Close to shoreline in shallow waters, tidal creeks and around boat ramps (almost invisible in water) Bell (up to 35cm diameter) + 3m long tentacles (up to 60 tentacles each) Tentacles contain millions of stinging cells (nematocysts) that inject venom upon skin contact. White welts appear frosted & become red whip-like -> permanent scarring. Large dose of venom (especially in small children) can cause rapid cardiorespiratory arrest and death within few min. Early cpr > anti-venom for greater survival benefit in cardiac arrest. Avoid - rubbing skin with towel, washing with fresh water, applying pbi.
