ENVIRONMENTAL EMERGENCIESTREATMENT
■ Immerse in 5% acetic acid (vinegar)to inactivate nematocysts. Alterna-
tives include:
■ Immersion in rubbing alcohol (isopropyl 40%)
■ Baking soda
■ Nofresh or tap water rinsing as this causes nematocytes to discharge via
osmotic gradient
■ If the nematocyte is still embedded in the skin, apply flour, or shaving
cream and shave.
■ Provide adequate analgesia.
■ Treat any allergic reaction.
■ Tetanus prophylaxis
■ Antivenom is available for severe box-jellyfish sting.
Octopus Bites
MECHANISM OFTOXICITY
■ Venom contains tetrodotoxin (TTX) →inhibition of voltage-gated Na+
channels→paralysis.
SYMPTOMS/EXAM
■ Local erythema
■ Paresthesias, flaccid paralysis
■ Respiratory failure
TREATMENT
■ Supportive therapy
■ Local wound care
■ No known antivenom exists.
Lizard Bites
The Mexican beaded lizard and the Gila monster are venomous lizards. Approx-
imately 70% of their bites are complicated by envenomation.
MECHANISMS OFTOXICITY
■ Venom is delivered by glands in the lower jaw into the laceration created
by the teeth →local and (rarely) systemic effects.
■ The lizard’s teeth may break and be left in the wound as a foreign body
and a cause for infection.
SYMPTOMS/EXAM
■ Crush and puncture wounds
■ Local erythema and pain
■ Systemic effects: Weakness, hypotension, and diaphoresis
TREATMENT
■ Supportive therapy
■ Remove animal if still attached.
■ X-ray to identify any foreign body
Stinger injury →Immerse in
hot water.
Nematocyte injury →
Immerse in acetic acid.Octopus bites can →flaccid
paralysis and respiratory
failure via tetrodotoxin.