Anyone that knows me, must appreciate how much I care about preventing medical problems and empowering people to take reasonable action in the event of an issue. This month, I thought I would concentrate on injuries caused by marine wildlife and the appropriate first aid measures.

 

 

The best general advice is, “be prepared” … find out about what local marine life there maybe, the water conditions and have (and take) a suitable first aid kit.

 

TYPES OF INJURIES:

• Contact toxins: stings caused by jellyfish, coral, sponges and sea urchins
• Injected toxins: caused by marine life such as stingrays, scorpionfish and cone snails
• Bites: from predators like barracuda, moray eel, sea snakes and sharks

GENERAL PREVENTIONS:

Typically, marine wildlife only injure people when touched or threatened. Therefore, the best prevention is to keep a respectful distance from any marine life and avoid touching coral and sponges! To achieve this, a few simple steps are advisable:

 

• Make sure you are up to date with routine vaccinations (especially tetanus).
• Find out which marine wildlife is common in the area. Do jellyfish or stingrays live in the waters? What about fire coral or sea urchins? What else?
• Watch your step: Injuries often occur in shallow waters by stepping onto the danger. So, wear protective water shoes when wading (thin shoes offer little protection against animals with spines e.g. stonefish, or sharp corals)
• Only put your hands and feet where you can see them i.e. not under ledges where animals could be hiding.
• It is best not to actively touch, feed, or engage with marine animals.

 

Finally, pack a suitable first aid kit and have it with you.

 

GENERAL FIRST AID:

Obviously, injuries caused by marine wildlife vary in severity: from small scratches, rashes, burning, itching, and pain on contact … to vomiting, cardiovascular collapse, respiratory difficulties with breathing, and even paralysis. Remember that small cuts can cause infections as bacteria, viruses, or other “bugs” enter the body.

 

All injuries need the same first aid: it is vital that all wounds are cleaned of debris and disinfected. This is important for everyone, but especially people with pre-existing conditions (such as, a weakened immune system – the elderly, diabetics, kidney disease, liver disease, cancer, blood disorders or HIV.)

 

Some injuries need different first aid: some issues do not need professional medical care but;

• Consideration should to be made about the requirement for removing stubborn debris to ensure proper would cleaning or appropriate pain management.
• If the wound is a puncture, a tetanus vaccination maybe advisable (even if the casualty is “in date”) and antibiotics may be needed to prevent infection (there are some “nasty” bugs out there!)
• It is recommended that an oral antihistamine is taken to try to prevent an allergic reaction.
• Always assess the casualty looking for the development of anaphylaxis (a severe and potentially life-threatening allergic reaction). If this occurs or looks possible, obtain emergency medical care. Some boats will have intramuscular (IM) adrenaline (epipen), IM steroids (such as hydrocortisone) and IM antihistamines available (so make sure they are with the party and that someone is certified to administer them!)

 

Definitely seek medical advice if: the casualty has facial or neck swelling, trouble breathing, a change in awareness or becomes unconscious (or if you feel this is a possibility.) These are the likely symptoms of anaphylaxis and the condition is a very urgent (minutes) situation.

 

SPECIFIC FIRST AID ADVICE:

 

CONTACT TOXINS: In general, injuries caused by jellyfish, sponges, coral, fire coral, anemones and sea urchins cause symptoms including skin redness, swelling, rash, burning, itching, and pain on contact. However, if left embedded in the skin, coral can cause pain and irritation for weeks. Anemones, fire coral, and jellyfish release barbed threads, making the injury very painful.

As a “quick reference first aid guide”:

Sponges: Rinse and dry, lift spikes with adhesive tape, apply a topical corticosteroid to reduce inflammation, and take an antihistamine.

Coral: Remove embedded coral by rinsing with seawater or a scrub brush and apply a topical antibiotic.

Sea urchin: Remove spines, cleanse the wound, soak in hot water, and apply a topical antibiotic.

Anemones: Remove tentacles, rinse with seawater, use ice to relieve pain, apply hydrocortisone, and take an antihistamine.

Jellyfish: Remove any tentacles, rinse with seawater, and scrape skin with a credit card, tweezers, or razor to remove any barbs. Follow by rinsing with vinegar or rubbing alcohol. Apply hydrocortisone and take an antihistamine. (Box jellyfish: find out if these are possible in the area and if antivenom is available. Pacific jellyfish stings are serious and can be fatal.)

Seabather’s eruption: Skin irritation caused by jellyfish and anemone larvae, usually underneath a person’s swimwear. Rinse with vinegar, apply a hydrocortisone to the affected area, and take an antihistamine if itchiness does not stop. Machine wash the swimwear.

 

What NOT to do with a jellyfish sting: Do NOT urinate on the wound, rub with sand or rinse with fresh water as all activate the barbs! Instead, it is advised to rinse with seawater or salt water, followed by application of vinegar. (The only exception to the vinegar rinse is a sting from the Portuguese Man-O-War jellyfish as vinegar causes it to further activate).

INJECTED TOXINS: If venom is injected by a stingray or scorpionfish, seek medical attention immediately for proper wound management. First aid includes soaking the affected area in hot water for 30-90 minutes (obviously on route to/ waiting for, definitive medical care). It is advised to find out if scorpionfish antivenom is available in any area where it is likely to be needed.

For cone snail toxin injection, immobilize the limb and apply pressure with a clean dressing. Seek medical attention for proper wound care and pain support.

 

BITES: The majority of predator bites are the result of the animal being provoked. Almost all will require definitive medical care.

 

Clearly this is only a short first aid “guide” and you should seek professional medical advice, by any means available to you, in the event of such a problem (just to be safe). However, I hope has been a helpful first aid/ interim measure!