SAQ 103 – Environmental Medicine – marine envenomation
Model Answer
Question 9. marine envenomation.
a. Box jellyfish history
- Tentacles seen.
- Immediate severe pain after the sting.
- Collapse or arrest on the beach.
b. Box jellyfish examination
- Severe distress, screaming, or irrational behaviour.
- Wheals, vesicles, or red-brown whip-like marks.
- Hypertension or tachycardia.
- Muscle spasm or paralysis.
c. Irukandji history
- No jellyfish or tentacle seen.
- Pain initially not severe.
- Systemic symptoms delayed by 30 minutes to 2 hours.
- Muscle aches or spasm, headache, sweating, restlessness, agitation, nausea, vomiting, respiratory difficulty, weakness, collapse, or sense of impending doom.
d. Irukandji examination
- Sweating.
- Hypertension.
- Tachycardia.
- Pulmonary oedema or heart failure.
e. Management modality roles
| Modality | Box jellyfish | Irukandji |
|---|---|---|
| Mainstay of treatment | Prolonged advanced life support if cardiac arrest occurs. | Control severe hypertension and supportive care. |
| Ice | No established role. | No established role. |
| Vinegar | Apply to inactivate nematocysts. | Recommendations vary; some texts advise vinegar, others do not. |
| Pressure immobilisation | Not recommended. | Not recommended. |
| Antivenom | Controversial; consider in severe box jellyfish envenomation. | No role. |
Comments are closed for this SAQ.