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Poisonous animals
 
Cnidarians (Jellyfish, Corals and Anemones)
 
Venomous fish
 
Scorpions
 
Spiders
 
Hymenopterans (Bees, Wasps and Ants)
 
Sea snakes
 
Terrestrial snakes
 
Miscellaneous animals
 
 
 
 
 
 
 
 

Emergency & clinical flowcharts

 

Signs and symptoms1
  First aid   Emergency medical treatment   Possible cause   Antivenom2
         
Local signs of a sting (see below) plus nausea, vomiting, abdominal pain, diarrhoea, urticaria, angio-oedema, bronchospasm, arterial hypotension (see Diagnosis & Treatment: First aid / lay people)
    Treatment of immediate-type allergic reactions, including anaphylactic shock
  All cnidarians
  
         
Unberable local pain;
skin lesions with typical ladder-like "cross-hatching pattern" (see Fig. 4.11);
cardiac dysfunction (arrhythmias, arterial hypotension), respiratory insufficiency;
cardiopulmonary failure within minutes possible (see Chironex fleckeri)
  Vinegar (4–6% acetic acid3), see Diagnosis & Treatment: First aid / lay people
  Oxygen;
commence or continue reanimation;
pain: pethidine 1–2 mg/kg body weight, repeat as needed;
respiratory insufficiency: endotracheal intubation and artificial respiration (see Diagnosis & Treatment: Hospital

  
  Chironex fleckeri
Chiropsalmus quadrigatus


 

MAVIN Antivenom index

         
Pain;
linear urticarial or papular skin lesions (see Fig. 4.11);
cardiac dysfunction (arrhythmias, arterial hypotension), respiratory insufficiency;
cardiopulmonary failure within minutes possible (see Physalia physalis);
haemolysis
      Physalia sp.
  
         
Pain, may be minimal;
local erythema, may be minimal (see Fig. 4.11);
"Irukandji syndrome" (can occur after a delay of up to several hours): cramping abdominal pain, back pain, limb pain, vomiting, state of anxiety, cardiac arrhythmias, arterial hypertension, pulmonary oedema, heart failure (see Carukia barnesi)
  Vinegar (4–6% acetic acid3), see Diagnosis & Treatment: First aid / lay people  
Oxygen;
pain: pethidine;
anxiety: diazepam;
arterial hypertension: phentolamine 5 mg initially

(see Diagnosis & Treatment: Hospital)

  Carukia barnesi and various other species
  
         
Extremities: acute regional vascular insufficiency distal to the sting (see Diagnosis & Treatment: Hospital)
    see Diagnosis & Treatment: Hospital   Various cnidarians
(see Diagnosis & Treatment: Hospital)
  
         
Extremities: mononeuritis multiplex distal to the sting (see Diagnosis & Treatment: Hospital)
    see Diagnosis & Treatment: Hospital   Various cnidarians
(see Diagnosis & Treatment: Hospital)
  
         
Eyes: pain, conjunctivitis, corneal oedema, iridocyclitis (see Diagnosis & Treatment: Hospital)   
see Diagnosis & Treatment: Hospital   Various cnidarians
(see Diagnosis & Treatment: Hospital)
  
         
Local in the region of the sting: acute (within minutes), painful linear or blotchy urticarial or papulovesicular skin lesions, erythema, (necrosis, ulceration)
    Treatment of pain: ice packs (see Diagnosis & Treatment: First aid / lay people);
Chironex fleckeri/Chiropsalmus quadrigatus, Physalia sp., Carukia barnesi, see above
  All cnidarians
  

 

1
See also the Clinical flowchart as a guide to the dynamics of envenoming.
2 See "Essentials of the management of envenoming and poisoning: 9. How is the appropriate antivenom chosen? When is it administered?".
If clinical information regarding the efficacy of an antivenom is available, it is presented in the relevant Biomedical database entry.
3 E.g. household vinegar.