92 DANGEROUS MARINE ANIMALS 



foreign substances into the wound. In the case of stingray and cat- 

 fish stings, the retrorse barbs of the spine may produce severe 

 lacerations with considerable trauma to the soft tissues. Wounds 

 of this type should be promptly irrigated, or washed but with cold 

 salt water or sterile saline if such is available. Fish stings of the 

 puncture-wound variety are usually small in size, and removal of 

 the poison is more difficult. It may be necessary to make a small 

 incision across the wound, and then apply immediate suction, and 

 possibly irrigation. At any rate, the wound should be sucked 

 promptly in order to remove as much of the venom as possible. 

 However, it should be kept in mind that fishes do not inject their 

 venom in the manner employed by venomous snakes, so at best, 

 results from suction will not be too satisfactory. 



There is a division of opinion as to the advisability and efficacy 

 of using a ligature in the treatment of fish stings. If used, the liga- 

 ture should be placed at once between the site of the sting and the 

 body, but as near the wound as possible. The ligature should be 

 released every few minutes in order to maintain adequate circula- 

 tion. Most doctors recommend soaking the injured member in 

 hot water for 30 minutes to one hour. The water should be main- 

 tained at as high a temperature as the patient can tolerate without 

 injury, and the treatment should be instituted as soon as possible. 

 If the wound is on the face or body, hot moist compresses should be 

 employed. The heat may have an attenuating effect on the venom 

 since boiling readily destroys stingray venom in vitro. The addi- 

 tion of magnesium sulfate or epsom salts to the water is believed 

 to be useful. Infiltration of the wound area with 0.5—2^ procaine 

 has been used with good results. If local measures fail to prove 

 satisfactory, intramuscular or intravenous demerol will generally 

 be efficacious. Following the soaking procedure, debridement and 

 further cleansing of the wound may be desirable. Lacerated 

 wounds should be closed with dermal sutures. If the wound is 

 large, a small drain should be left in it for a day or two. The in- 

 jured area should be covered with an antiseptic and sterile dressing. 



Prompt institution of the recommended treatment usually elimi- 

 nates the necessity of antibiotic therapy. If delay has resulted to 

 any extent, the administration of antibiotics may be desirable. A 

 course of tetanus antitoxin is an advisable precautionary measure. 



The primary shock which follows immediately after the stinging 

 generally responds to simple supportive measures. However, sec- 

 ondary shock resulting from the action of stingray venom on the 

 cardiovascular system requires immediate and vigorous therapy. 



