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37
E L L Y WR A Y
The Medic’s PersPecTive
Almost all fish-spine punctures will be painful and result
in some inflammation. Even in punctures from species
whose spines are not venomous, our immune systems
respond to the myriad antigens these wounds introduce.
Injuries from members of family scorpaenidae (e.g., lion-
fish, scorpionfish and stonefish) should always be man-
aged proactively; in addition to introducing a plethora
of antigens, these punctures also inject toxins with
vasoactive (affecting blood-vessel dilation) and hemolytic
(blood-cell destroying) effects. The extension of swelling
beyond the wound’s edges that Wray described as well
as the purpling of her nail bed and skin were probably
due to these toxin-specific effects.
Hot water can be quite effective for controlling pain.
Definitive treatment is usually a matter of treating the
symptoms, although specific antivenom may be available
for stonefish envenomations.
Lionfish stings should never be underestimated. As
Wray describes, pain can be significant, and secondary
complications can be much more so. Whether you
need first-aid training for hazardous marine life injuries,
insurance coverage for accidents or expert consultation,
DAN is here for you.
— Matias Nochetto, M.D.
share Your sTorY
Has DAN been there for you? Tell us about it at ThereForMe@dan.org.
Wray’s thumb healing after her painful encounter with a lionfish.
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