- Box jellyfish
- Can cause sudden cardiac death
- remove tentacles and put vinegar on
- Ice for pain, opiates
- May need CPR, oxygen, inotropes
- IV antivenom
- Irukandji
- Small, can get through nets
- Back, abdominal and muscle pains
- Chest pain, sweating, anxiety, impending doom, headache, nausea, vomiting
- Wash sting with salt water, remove tentacles
- Hot water immersion
- No vinegar
- Bluebottle
- Intense local pain, linear red eruption
- Systemic effects are rare
- Remove/wash with sea water (not fresh water)
- Hot water for 20 minutes – (vinegar not helpful)
- Snake bite
- Clinical
- Local effect
- Nausea, vomiting, headache, abdo pain, diarrhea diaphoresis, collapse
- Complications
- Coagulopathy -V ICC – most important in Aus
- Neurotoxicity
- Myotoxicity – rhabdo
- Acute kidney injury
- Treatment
- Pressure bandage over the bite site and whole effected limb (within 4 hours)
- Discuss with toxicology
- Immobilize limb and patient
- Analgesia
- Assess for envenomation – give antivenom if indicted (no need after 12 hours)
- consider removing bandage if well and normal lab markers
- Continue regular monitoring, Antivenoms all have a risk of anaphylactic reaction – need to be in resuscitation setting
- Funnel web spider
- Big black spider and unwell — manage presumptively
- Pain and bleeding at site
- Localized neuromuscular toxicity
- Other – autonomic, neuromuscular, cardiovascular, respiratory, CNS
- High risk mortality
- Pressure bandage, immobilize until antivenom available
- Anti-venom available if severe – not required after 2 hours
- Monitor for 12-24 hours
- Consider tetanus
- analgesia
- Red back spider
- Significant pain and systemic effects, regional sweating, erythema, parasthesisa, abdominal/chest/back pain
- Not usually fatal
- Analgesia, ice/heat packs, tetanus
- Don’t do pressure bandage
- Pain can continue 5 days\
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