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Stingray Envenomation

My daughter was walking in the surf near Panama City, Fla., when she got stung. She was barefooted and said something wrapped up around her foot right before she felt the pain. One of the lifeguards pulled out a small spine, and then she saw a doctor. He put her on an antibiotic, but the cut on her foot doesn't seem to be healing. What should she do?

A stingray does its damage by lashing upward in defense with a muscular tail-like appendage, which carries up to four sharp, swordlike stingers. The stingers are supplied with venom, so that the injury created is both a deep puncture or laceration and an envenomation.
The pain from a stingray wound can be excruciating and accompanied by bleeding, weakness, vomiting, headache, fainting, shortness of breath, paralysis, collapse and occasionally, death. Most wounds involve the feet and legs, as unwary waders and swimmers tread upon the creatures hidden in the sand.

The Treatment

  1. Rinse the wound with whatever clean water is available. Immediately immerse the wound in non-scalding hot water to tolerance (110 to 113 F/43.3 to 45 C). This may provide some pain relief. Generally, it is necessary to soak the wound for 30 to 90 minutes. Gently extract any obvious piece of stinger.

  2. Scrub the wound with soap and water. Do not try to sew or tape it closed - doing so could promote a serious infection by "sealing in" harmful bacteria.

  3. Apply a dressing and seek medical help. If more than 12 hours will pass before a doctor can be reached, start the injured person on an antibiotic (ciprofloxacin, trimethoprim-sulfamethoxazole or doxycycline) to oppose Vibrio bacteria.

  4. Administer pain medication sufficient to control the pain.

Prevention of Stingray Injuries

  1. Always shuffle your feet when wading in stingray waters.

  2. Always inspect the bottom before resting a limb in the sand.

  3. Never handle a stingray unless you know what you are doing or unless the stingrays are definitely familiar with divers and swimmers (e.g., the rays in "Stingray City" off Grand Cayman Island in the British West Indies). Even then, respect them for the wild creatures they are - the less you handle them the better for them and for you, too.

    For more information on marine life injuries, see the complete article by Paul S. Auerbach, M.D., M.S. on Marine Life Trauma from the Jan/Feb 1998 issue of Alert Diver.