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First aid for jellyfish envenomation
Toxicoa, Vol . 22, No. 4, pp. 663-667, 1984 .
Perpmoa Pros Ltd.
Printed in Grec Britain.
REVIEWS BABAEY, O. G. and YAZDZFIUMAEV, D. (1983) (Clinical picture and treatment of snake bites.] Khirurgiya (2), 61-66 (in Russian) .
TxE Auraoles reviewed 273 cases of snakebite inflicted by cobras, gyurza (Ylefa?) and shchitomordnik(7) . Twelve per cent of the patients reached definitive care in less than 30 min of the bite . Local symptoms and signs included pain, swelling, bleeding from fang punctures, ecchymosis and the formation of blebs. Systemic manifestations included nausea and vomiting, hematuria, oliguria, paresis, respiratory distress, tachycardia, hypotension and decreased hemoglobin . In some cases there was bleeding from the gums and digestive tract. Antivenin was given in almost 90% of the cases. Poisoning was mild in 4S .S%, moderate is 31 .57a and severe in 23 .1 ~. Five patients died . No mention is made of bites without envenomation, but it is assumed that these are included in the "mild." The authors suggest suction, immobilization and antivenin as the most important therapeutic measures . Surgery is restricted to debridement. Tourniquets and incisions are not "justified". "Trophic ulcers, ankyloses and deformities in the joints developed in 36 patients ."
FINDLAY E. RUSSELL
BueNErr, J. W. SIId CALTON, G. J. (1983) Response of the box-jellyfish (Chironex,Jlerkerr) cardiotoxin to intravenous administration of verapamil. Med. J. Aust. (2), 192-194.
IN MICE, the authors demonstrated the effectiveness of the calcium antagonist, verapamil, in prolonging death time due to Chironex Jleckeri venom. Unfortunately, the use of an ill~efined unit dose (mouse-lethal units) detracts from a critical statistical evaluation, and a range of 3 -1440 min for death times may cause some upturned pharmacological eyebrows . Nevertheless, the data are interesting. FINDLAY E. RUSSELL
MARETIC, Z. S. and RusseLL, F. E. (1983) Stings by the sea anemone Anemonia svlcata in the Adriatic Sea. Am . J. trop. Med. Hyg. 32, 891- 896. THE SEA ANEMONE Anemonia sulcata is the clinically most important Actinaria in the Adriatic Sea. Between
1965 and 1980, SS patients stung by this cnidarian were seen at the Pules Medical Center in Istria, Yugoslavia . The majority of injuries were inflicted upon the upper extremities, chest or abdomen. Pain and the appearance of small blanched papules surrounded by slightly reddened and edematous bases were the usually initiating manifestations . Linear lesions were sometimes seen . Veaicles, sometimes filled with serous fluid, localized discoloration and the formation of bullae sometimes followed . Somnolence, dizziness, nausea, vomiting, muscle aches and lid edema were reported in some cases. The treatment of these injuries in the northern Adriatic Sea and elsewhere is discussed. (Authors' Abstract) BURNETr, J. W., RUBINSCEIN, H. and CALi'ON, G. J. (1983) First aid for jellyfish envenomation. Sth . med. J. 76, 870-872. TFIE DIFFICULTY of conducting either a clinical or experimental study on the efficacy of remedies for stings by jellyfishes, Portuguese man-of-war and anemone stings is well known to every physician who has attempted such an investigation . The present study was conducted by an old pro and is about as close to a well-controlled experimental investigation as can be hoped. Burnett and his wlleagues studied the various immediate first-aid measures that might be used following stings by the sea nettle, Chrysaora quinquecirrha, and the Portuguese man-of-war, Physalia physalis. They employed about a dozen well known "tcmedies" to determine their ability to prevent nematocyst rupture and found that a baking soda slurry was a good inhibitor of nematocyst discharge for the nettle, while vinegarwas best for man-0f-war discharges . This is an informative study and bears out more basic concepts on which there have been some differences of opinion between biologists and physicians. FINDLAY E. RUSSELL STROM, G. B., JR, BOSWELL, R. N. and JACOBS, R. L. (1983) In vivo and in vitro comparison of fire ant venom and fire ant whole body extract . J. Allergy Clin . Immun . 72, 46-53. TFURTY-0NE of 34 patients with a history of sensitivity to the venom of the fire ant, Solenoptsis invicta or 665
Perpmoa Pros Ltd.
Printed in Grec Britain.
REVIEWS BABAEY, O. G. and YAZDZFIUMAEV, D. (1983) (Clinical picture and treatment of snake bites.] Khirurgiya (2), 61-66 (in Russian) .
TxE Auraoles reviewed 273 cases of snakebite inflicted by cobras, gyurza (Ylefa?) and shchitomordnik(7) . Twelve per cent of the patients reached definitive care in less than 30 min of the bite . Local symptoms and signs included pain, swelling, bleeding from fang punctures, ecchymosis and the formation of blebs. Systemic manifestations included nausea and vomiting, hematuria, oliguria, paresis, respiratory distress, tachycardia, hypotension and decreased hemoglobin . In some cases there was bleeding from the gums and digestive tract. Antivenin was given in almost 90% of the cases. Poisoning was mild in 4S .S%, moderate is 31 .57a and severe in 23 .1 ~. Five patients died . No mention is made of bites without envenomation, but it is assumed that these are included in the "mild." The authors suggest suction, immobilization and antivenin as the most important therapeutic measures . Surgery is restricted to debridement. Tourniquets and incisions are not "justified". "Trophic ulcers, ankyloses and deformities in the joints developed in 36 patients ."
FINDLAY E. RUSSELL
BueNErr, J. W. SIId CALTON, G. J. (1983) Response of the box-jellyfish (Chironex,Jlerkerr) cardiotoxin to intravenous administration of verapamil. Med. J. Aust. (2), 192-194.
IN MICE, the authors demonstrated the effectiveness of the calcium antagonist, verapamil, in prolonging death time due to Chironex Jleckeri venom. Unfortunately, the use of an ill~efined unit dose (mouse-lethal units) detracts from a critical statistical evaluation, and a range of 3 -1440 min for death times may cause some upturned pharmacological eyebrows . Nevertheless, the data are interesting. FINDLAY E. RUSSELL
MARETIC, Z. S. and RusseLL, F. E. (1983) Stings by the sea anemone Anemonia svlcata in the Adriatic Sea. Am . J. trop. Med. Hyg. 32, 891- 896. THE SEA ANEMONE Anemonia sulcata is the clinically most important Actinaria in the Adriatic Sea. Between
1965 and 1980, SS patients stung by this cnidarian were seen at the Pules Medical Center in Istria, Yugoslavia . The majority of injuries were inflicted upon the upper extremities, chest or abdomen. Pain and the appearance of small blanched papules surrounded by slightly reddened and edematous bases were the usually initiating manifestations . Linear lesions were sometimes seen . Veaicles, sometimes filled with serous fluid, localized discoloration and the formation of bullae sometimes followed . Somnolence, dizziness, nausea, vomiting, muscle aches and lid edema were reported in some cases. The treatment of these injuries in the northern Adriatic Sea and elsewhere is discussed. (Authors' Abstract) BURNETr, J. W., RUBINSCEIN, H. and CALi'ON, G. J. (1983) First aid for jellyfish envenomation. Sth . med. J. 76, 870-872. TFIE DIFFICULTY of conducting either a clinical or experimental study on the efficacy of remedies for stings by jellyfishes, Portuguese man-of-war and anemone stings is well known to every physician who has attempted such an investigation . The present study was conducted by an old pro and is about as close to a well-controlled experimental investigation as can be hoped. Burnett and his wlleagues studied the various immediate first-aid measures that might be used following stings by the sea nettle, Chrysaora quinquecirrha, and the Portuguese man-of-war, Physalia physalis. They employed about a dozen well known "tcmedies" to determine their ability to prevent nematocyst rupture and found that a baking soda slurry was a good inhibitor of nematocyst discharge for the nettle, while vinegarwas best for man-0f-war discharges . This is an informative study and bears out more basic concepts on which there have been some differences of opinion between biologists and physicians. FINDLAY E. RUSSELL STROM, G. B., JR, BOSWELL, R. N. and JACOBS, R. L. (1983) In vivo and in vitro comparison of fire ant venom and fire ant whole body extract . J. Allergy Clin . Immun . 72, 46-53. TFURTY-0NE of 34 patients with a history of sensitivity to the venom of the fire ant, Solenoptsis invicta or 665