SinaiEMSinaiEMSinaiEMSinaiEM
  • Faculty
  • Faculty

What Lies Beneath

    Home tox What Lies Beneath
    NextPrevious

    What Lies Beneath

    By sinaiem | tox | Comments are Closed | 29 May, 2015 | 0

    24 y/o male working at the local aquarium presents with right hand redness, pain, and swelling after handling an exotic fish. He is able to snap a picture of the fish before presenting to the ED. What’s your diagnosis?

    Image not available.

    Stonefish (genus Synanceja) is a spiny bottom-feeding fish disguised to blend in with the rocky sea bottom. Found in the Pacific and Indian oceans, the spines of the fish are connected to venom filled glands at the bases.

    Immediate, severe pain with rapid wound cyanosis and edema that may progress up the injured extremity. Pain reaches a maximum after 30 to 90 minutes and usually resolves over 6 to 12 hours, although pain may persist for days. May be associated with seizures, limb paralysis, hypertension, respiratory distress, or hypotension in systemic toxicity.

    The wound should be cleaned and immersed in warm water. Stonefish antivenom can be given IV or IM. Anecdotal reports suggest it provides effective relief from pain. Administration is indicated for systemic toxicity or refractory pain.

    http://accessemergencymedicine.mhmedical.com/content.aspxsectionid=65101891&bookid=1163&jumpsectionID=65101996&Resultclick=2&q=stonefish#gol_ch119fg3

    No tags.
    NextPrevious
    • Resident Login
    • Schedules
      • Qgenda
      • Schedule Request Form (All Sites)
      • Moonlighting Requests
        • Sinai Moonlighting Request Form
        • Elmhurst Moonlighting Request Form
        • BI Moonlighting Request Form
        • PEM Moonlighting Request Form
        • MSBI Urgent Care Moonlighting Request Form
      • Moonlighting Payment Form
    • PEARL PUSHERS
    • Shift Resources
      • Consent Forms
      • Regional Anesthesia Guide
      • Critical Care Protocols
      • Shout Out Form
      • Checklists
        • Start of Shift Checklists
          • General Start of Shift Checklist (EMUpdates)
          • Cardiac
          • Resus Checklist 5.0
          • Resus
          • Trauma
          • RACC Restocking Checklist
        • Intubation Checklist (EMUpdates)
        • PSA Checklist (EMUpdates)
      • PEM Resources
        • CHOP ED Clinical Pathways
        • StatPearls
        • PEM Database
      • Mental Health Resources
    • Resus
      • Resus Checklist 5.0
    • Ultrasound
    • People
      • Residents
      • Faculty
      • Division of Critical Care
      • PEM Fellows
      • Residency Newsletters
        • Summer 2017
        • Winter 2016
        • Summer 2015
      • Alumni Map
    • Applicants
      • EMIG
        • EMIG EMS Ride-Alongs
      • Residency Applicants
      • MS4 Clerkship Applicants
      • Wellness
        • Resiliency Toolbox
        • Mental Health Resources
        • New York City things-to-do
          • Viewing.NYC
        • Free Write May 2017
        • Other Wellness Information
        • Having Children During Residency – Pregnancy tips for new moms and dads
    SinaiEM