Lionfish Sting Treatment

[Vone Research]

We have found some Lionfish off the coast of Pompano Beach, Florida. Does anyone know how to treat a lionfish sting?

 

[Cave Diver]

From Lionfish and Stonefish: Treatment & Medication - eMedicine Emergency Medicine

Prehospital Care

* Prehospital care should address recognition of the injury as a potential envenomation, gentle removal of visible spines, direct pressure to control bleeding, administration of analgesia, and transport for definitive medical evaluation.
* Recognition of serious systemic symptoms and prompt institution of appropriate life-saving procedures, such as cardiopulmonary resuscitation (CPR) and treatment for anaphylaxis, should be paramount in the prehospital care setting.

Emergency Department Care

Emergency department (ED) management of Scorpaenidae envenomations involves addressing the venom exposure as well as the accompanying inflicted trauma. General rules of therapy include prompt analgesia, wound management, antivenom administration, and supportive treatment for significant envenomations.

* CPR and advanced cardiac life support (ACLS) procedures are rarely indicated but always take absolute precedence.
* Wound debridement
o Gentle manual removal of obviously protruding spines prevents further penetration or breakage.
o With proper anesthesia, surgical removal of embedded spines is indicated when they are in proximity to joints, nerves, or vessels.
o Weight-bearing surfaces may require removal of spines to prevent chronic pain.
o Always irrigate copiously after adequate anesthesia.
* Hot water immersion technique
o Heat treatment is widely recommended as effective initial treatment for envenomations by Scorpaenidae, as well as echinoderms, stingrays, and other venomous spine injuries.
o The affected limb should be immersed in water no warmer than 114 degrees Fahrenheit, or 45 degrees Celsius.
o Be careful not to inflict thermal burns by placing an insensate limb (as a result of local anesthesia or decreased sensitivity as a result of pain) into scalding water.
o Local or regional anesthesia, if available, is a suggested means of adjunctive analgesia.

Some sources claim that immersion in cold and exposure to heat have both been shown effective in neutralizing the poison in the spines of Lionfish to make them safe to handle. As always, use caution around venomous animals.