Bites by marine animals and fish

There are poisonous and non-poisonous bites from sea animals and fish. Non-poisonous but extensive damage can be caused by sharks, moray eels, eels, barracudas, etc. In these cases, emergency care is provided according to the standard wound treatment scheme: stopping bleeding, replenishing the volume of circulating blood, pain relief.

Jellyfish and polyps infect with a toxic substance contained in stinging cells and causing anaphylactic reactions, sometimes with a fatal outcome. When in contact with a jellyfish, a person experiences severe burning and pain, hyperemia and swelling of the skin, sometimes blisters. After 15-20 minutes, pain in the muscles and joints, chills, a feeling of pressure behind the breastbone, and in some people, bronchospasm and intestinal disorders occur. These symptoms subside after 2-4 days. Some jellyfish (sea wasp, physalia) contain a potent neuroparalytic poison of immediate action, which can lead to respiratory and cardiac arrest.

First aid in case of development of pathological symptoms due to contact with jellyfish and polyps consists of removing the remains of the jellyfish from the skin and treating the skin with a 70% ethanol solution or a 3% vinegar solution, after which an oil compress or a nourishing cream on a fat basis is applied. In addition, intramuscular administration of antihistamines, pain relief with non-narcotic and narcotic analgesics, and anti-shock measures are necessary. It is not recommended to wash the place of contact with the jellyfish with fresh or sea water. In the first case, the stinging cells are destroyed with the release of toxin, in the second case, the dried stinging cells are “revived”. In case of contact with jellyfish containing neuroparalytic poison, timely cardiopulmonary resuscitation is important.

Neuroparalytic poison can also affect some species of sea fish (stingray, lionfish, scorpionfish, sea dragon, etc.), mollusks (cones), blue octopus. Clinical picture after a bite (injection): local signs of inflammation (pain and erythema), suffocation, weakness, bradycardia, convulsions, cardiac and respiratory arrest.

In such cases, the wound should be washed with sea water. To neutralize the poison, it is advisable to hold the damaged part of the body in hot water (40-50 °C) for 30-90 minutes. A loose venous tourniquet is applied to the affected limb proximal to the injection site (no later than the first 15 minutes) or a pressure bandage. It is advisable to perform a local novocaine block, intramuscular administration of antihistamines and analgesics, and detoxification therapy. For injections of some species of sea urchins or stingrays, early administration of naloxone as an analgesic antagonist at 0.01 mg/kg is recommended. In case of cardiac and respiratory arrest, cardiopulmonary resuscitation is performed.

Poisoning can be caused by eating certain types of commercial fish (tuna, sea bass, mackerel, etc.) that feed on phytoplankton containing a neurotoxic poison called ciguatoxin. The disease is called "ciguatera". The clinical picture of poisoning is dominated by dyspeptic symptoms, numbness of the tongue and lips, hallucinations, impaired temperature sensitivity, and in severe cases, cardiovascular failure and respiratory arrest.

In cases of such poisoning, three gastric lavage with water at a rate of 15-20 ml/kg is necessary, activated carbon is administered into the stomach up to 1 g/kg, and a 10% sodium sulfate solution at a rate of 200-250 mg/kg is used as a saline laxative. Oxygen therapy with 50% oxygen, hemodilution, and artificial ventilation are indicated if necessary.

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