Stingray envenomation is common along coastal regions. The study retrospectively reviewed 119 cases of stingray envenomation presenting to an emergency department over 8 years. Hot water immersion provided effective pain relief in 88% of acute cases within 30 minutes without other analgesics. Prophylactic antibiotics were recommended due to high risk of bacterial infection in puncture wounds. Radiography failed to detect stingray barbs in wounds.

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Artykuł - szczegóły
Journal of Emergency Medicine
2007 | 33 | 1 | 33-37
Stingray Envenomation: A Retrospective Review of Clinical Presentation and Treatment in 119
Cases
Richard F. Clark Robyn Heister Girard Daniel Rao Binh T. Ly Daniel P. Davis
Abstrakty:
EN Stingray stings are common along coastal regions of this country and the world. The tail of the stingray contains a barbed stinger attached to a
venom gland and contained within an integumentary sheath. During a sting, the stinger and sheath can become embedded in the soft tissue of the
victim, and venom is injected into the wound. Stingray venom most often causes severe pain on contact, although the exact mechanism of toxicity
is not certain. Hot water immersion of the stung extremity has been reported to be effective in relieving pain associated with the envenomation, but
large studies of this therapy have not been performed. We retrospectively reviewed stingray stings presenting to our Emergency Department (ED)
over an 8-year period. Cases were divided into acute (group 1, within 24 h of the sting) and subacute (group 2, 24 h or more after the sting)
presentations. Charts were abstracted for information concerning the victim’s history, physical examination, treatment, diagnostic imaging, and
outcome, including the effectiveness of hot water immersion as analgesia, and use of antimicrobials. A total of 119 cases were identified and
abstracted, 100 in group 1 and 19 in group 2. Of the group 1 patients initially treated with hot water immersion alone, 88% had complete relief of
pain within 30 min without administration of any other analgesic. In the patients who initially received a dose of analgesic along with hot water
immersion, none required a second dose of analgesics and all had complete pain relief before discharge. There were no adverse effects (such as
thermal burns) with this therapy. Analysis of infectious complications in group 1 patients demonstrated a significant number of patients returning to
the ED with wound infections when prophylactic antibiotics were not administered at initial presentation. Our findings suggest that hot water
immersion was effective in decreasing or eliminating the pain associated with stingray envenomation in our series. Due to the high potential for
bacterial contamination in these puncture wounds, standard antibiotic prophylaxis may be prudent. Although stingray barbs can be radio-opaque,
radiography in our series failed to detect barbs or other foreign bodies in stung extremities, although no barbs or other stinger material were found
on inspection of wounds.
Słowa kluczowe:
EN stingray sting envenomation venom treatment
Wydawca: Elsevier Science
Czasopismo: Journal of Emergency Medicine , ISSN 07364679
Rocznik: 2007
Tom: 33
Numer: 1
Strony: 33-37
Twórcy:
autor
autor
autor
autor
autor
Richard F. Clark
Department of Emergency Medicine, University of California, San Diego Medical Center, San Diego, California
Division of Medical Toxicology, University of California, San Diego Medical Center, San Diego, California
Robyn Heister Girard
Department of Emergency Medicine, University of California, San Diego Medical Center, San Diego, California
Daniel Rao
Department of Emergency Medicine, University of California, San Diego Medical Center, San Diego, California
Division of Medical Toxicology, University of California, San Diego Medical Center, San Diego, California
Binh T. Ly
Department of Emergency Medicine, University of California, San Diego Medical Center, San Diego, California
Division of Medical Toxicology, University of California, San Diego Medical Center, San Diego, California
Daniel P. Davis
Department of Emergency Medicine, University of California, San Diego Medical Center, San Diego, California
Bibliografia:

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ICM UW 2005-2014
1. Meyer, P.K., "Stingray injuries", Wilderness Environ Med, vol. 8, 1997, p.24-28
2. Auerbach, P.S., "Envenomation by aquatic vertebrates", Auerbach, P.S. (Eds.), Wilderness medicine, 2001, 4th edn., p.1488-1506
3. Stone, D.B.& Koutouzis, T.K., "Soft tissue foreign body removal", Roberts, J.R.& Hedges, J.R. (Eds.), Clinical procedures in emergency medicine,
2004, 4th edn., p.694-716
4. Vijayasekaran, V., "Stingray envenomation or iatrogenic thermal burn", ANZ J Surg, vol. 5, 2001, p.323-325
5. Barber, G.R.& Swygert, J.S., "Necrotizing fasciitis due to Photobacterium damsela in a man lashed by a stingray", N Engl J Med, vol. 342, 2000,
p.824
6. Polack, F.P.& Coluccio, M.& Ruttimann, R.& Gaivironsky, R.A.& Polack, N.R., "Infected stingray injury", Pediatr Infect Dis J, vol. 17, 1998, p.349, 360
7. Otten, E.J.& Blomkalns, A.L., "Venomous animal injuries", Marx, J.A.& Hockberger, R.S.& Walls, R.M. et al. (Eds.), Emergency medicine: concepts
and clinical practice, 2002, 5th edn., p.785-800
8. Evans, R.J.& Davies, R.S., "Stingray injuries", J Accid Emerg Med, vol. 13, 1996, p.224-225
9. Isbister, G.K., "Venomous fish stings in tropical northern Australia", Am J Emerg Med, vol. 19, 2001, p.561-565
10. Tomaszewski, C., "Aquatic envenomations", Ford, M.D.& Delaney, K.A.& Ling, L.J.& Erickson, T. (Eds.), Clinical toxicology, 2001
11. Moyles, B.G.& Wilson, R.C., "Stingray spine foreign body in the foot", J Foot Surg, vol. 28, 1989, p.30-32
12. Cook, M.D.& Matteucci, M.J.& Lall, R.& Ly, B.T., "Stingray envenomation", J Emerg Med, vol. 30, 2006, p.345-347
Języki publikacji: EN
Kolekcja: Elsevier
Identyfikator YADDA: bwmeta1.element.elsevier-61ae0a53-5570-3fad-b216-5816206956a1
Identyfikatory: DOI 10.1016/j.jemermed.2007.03.043