CSL Antivenom Handbook

First Aid for Marine Bites and Stings

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First Aid for Stonefish Sting

• If the patient is still in the sea, immediately remove from the water.

• Immerse the stung limb in hot water, ensuring first that it is not so hot that skin damage may occur.

• If the patient has not had tetanus immunisation booster within the last 5 years, ensure this is given by the local doctor.

• Seek medical help.

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First Aid for Other Fish Stings

• If the patient is still in the sea, immediately remove from the water.

• Immerse the stung limb in hot water, ensuring first that it is not so hot that skin damage may occur.

• If the patient has not had tetanus immunisation booster within the last 5 years, ensure this is given by the local doctor.

• If the wound becomes more red and painful after 24 hours seek medical help (possible secondary infection).

First Aid for Stingray Injuries

• If the patient is still in the sea, immediately remove from the water.

• Staunch any profuse bleeding with application of local pressure bandage.

• Immerse the stung limb in hot water, ensuring first that it is not so hot that skin damage may occur.

• Unless the wound is a trivial one confined to a limb, medical help should be sought urgently.

• If the patient has not had tetanus immunisation booster within the last 5 years, ensure this is given by the local doctor.

• If the wound becomes more red and painful after 24 hours seek medical help (possible secondary infection).

First Aid for Blue ringed octopus bites

• If the patient is still in the sea, immediately remove from the water.

• Maintain vital functions, especially respiration; if impaired (use of "ABC").

• Apply a pressure immobilisation bandage, as for snakebite.

• Seek urgent medical help.

• If the wound becomes more red and painful after 24 hours seek medical help (possible secondary infection).

First Aid for Box Jellyfish Stings

• If the patient is still in the sea, immediately remove from the water, avoiding further stings (use caution as the tentacles may be difficult to see).

• Immediately douse the stung area with copious quantities of household vinegar.

• Some authorities recommend that if the sting involves more than half of one limb in area, then apply a pressure immobilisation bandage and douse with further copious vinegar. There is recent evidence suggesting a pressure immobilisation bandage may actually worsen envenoming. This question is currently unresolved.

• Maintain vital functions, if impaired (use of "ABC"). If the patient has no pulse then use external cardiac compression and keep this going, if necessary, for a prolonged period, with an optimistic outlook.

• Urgently seek medical help.

• Cold packs are often helpful for pain relief.

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First Aid for Other Jellyfish Stings

This is more controversial and dependant on species, but for some, notably the bluebottle (Portuguese man-o-war) vinegar is not appropriate. Water (even ice water) should not be used on any jellyfish sting, as this may increase envenoming. Application of a cold pack is always useful.

First Aid for Sea Snake Bites

As for other snake bites, using pressure immobilisation method.

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