Is it an Emergency?
This is relevant for all animals belonging to Venomous Fish.
Is it likely that the patient had an accident due to a venomous fish?
Inquire
- time of the sting
- local, possibly regional pain
- nausea, vomiting, diarrhoea
Assess
- state of consciousness
Measure
- blood pressure/pulse
- respiratory rate
- oxygen saturation (pulse oximeter)
Observe/investigate
- (very) painful puncture sites
- swelling around the puncture site
- bleeing from the puncture site
- evidence for a deep and/or penetrating wound (thoracic/abdominal cavity/pericardial space, inner organs, blood vessels, nerves) (in particular imporant in stingray accidents)
- evidence of blood loss (haemorhagic shock)
- number of puncture sites (important in stonefish stings for assessment of the amount of venom injected and to determine the antivenom dose)
- local/regional swelling,
- clinical signs of cardiovascular disturbances, such as cardiac dysrhythmias, arterial hypotension, shock.
Is it likely that injection of venom has taken place?
Diagnostics
Inquire re:
- time of the sting,
- local, possibly regional pain,
- nausea, vomiting, diarrhoea.
Assess:
- state of consciousness.
Measure:
- blood pressure/pulse,
- respiratory rate.
Observe/investigate:
- puncture sites,
- number of puncture sites (important in Stonefish stings for assessment of the amount of venom injected and to determine the antivenom dose),
- local/regional swelling,
- clinical signs of cardiovascular disturbances, such as cardiac dysrhythmias, arterial hypotension,
- signs of paralysis.