Tuesday, December 30, 2008

Stonefish Poisoning

A few days ago I was lying on the sand at Tasi Tolu, mesmerized while photographing a lacy scorpionfish. I generally anchor myself in the sand with a steel pointer and stay a few inches off the bottom. And it's a good thing. I felt something moving under me and raised off the bottom to discover a small stonefish (about 20cm). This brush with danger made me consider what I would have done had I been 'stung' by the dorsal spines of the stonefish...especially given the lack of medical services here in Timor.

So here's a bit of advice from the Wildness Medical Society in Australia.

Proper management of stonefish poisoning involves immediate evaluation and stabilization of the patient. The wounds should be explored and copiously irrigated using sterile techniques. This cleanses the wound area and may remove venom as well as components of the spine, slime, and sand. Any foreign material left in the wound is likely to delay or arrest the healing process. Stonefish venom is heat labile; therefore, hot soaks (115°F/45°C) should be performed for 30 to 90 minutes or until the pain is relieved and does not recur. The wound may be infiltrated with local anesthetic without epinephrine if pain relief is required. Systemic analgesics or narcotics are rarely needed. General wound care should be administered, including antibiotics if indicated. The affected area should be elevated. Antivenom administration should be considered in cases of severe stonefish poisoning. This should be given as soon as possible after the initial sting, preferably within 48 hours.

Let's hope we never have to apply this knowledge, but there's more info if you follow the link to WMS.

Note: Lidocaine, xylocaine, prilocaine and mepivicaine (Isocaine) are common local anesthetics that are available without epinephrine.