Stingrays have venom which is contained in one or more spines located on the dorsum of the animal’s tail. Most injuries occur when one steps on the fish while wading in ocean surf, bay, or slough which causes the animal to thrust its tail upward and forward driving the dorsal spine or spines into the foot or leg. This action causes the integumentary sheath surrounding the spine to rupture releasing the venom into the victims tissues, inflicting immediate severe pain. At times the pain can spread rapidly, reaching its greatest intensity in less than 90 minutes, however it is often limited to the area of the injury. If untreated the pain may persist but will gradually diminish over 6 to 48 hours. Commonly syncope, weakness, nausea and anxiety may occur, partially due to vasodialation. Lymphangitis, vomiting, sweating, diarrhea, cramps, inguinal or auxiliary pain and respiratory distress can also occur.
A wound inflicted by a stingray is often jagged, bleeds freely, and can be contaminated with parts of the integumentary sheath. The edges of the wound are often discolored, and some localized tissue damage may occur; and edema and swelling generally are associated with the injury.
TREATMENT FOR STINGRAY INJURIES
Injuries should be immediately irrigated with the available water. If the integumentary sheath is visible in the wound it should be removed. The area affected should be submerged in water as hot as can be tolerated for 30-90 minutes. The wound should be again examined for remnants of the sheath and debrided. The appropriate anti-tetanus agent should be administered, and the injured area kept elevated for several days. An antimicrobial agent may be necessary, and the wound may need surgical closure.
In case of delay of initial first aid, the wound my be anesthetized locally with lidocaine; regional blocks my offer relief. Meperidine IM can be used for pain. The primary shock that sometimes follows stingray injuries usually responds to simple supportive measures.