Venomous first aid
BY VIRGINIA WINDER - Taranaki Daily News Last updated 12:28 12/03/2009
Should vinegar be used on a jellyfish sting? Virginia Winder checks out how to deal with New Zealand's venomous creatures.
A thread of blue wraps around the body surfer's hand and sticks there, like chewing gum.
It feels like that thread is on fire. It's burning her hand and she can't pull the damn thing off because it's entwined around her fingers. Finally, with help from her husband, the stinger is gone, but the pain remains.
She composes her face so the kids can't see anything is wrong and she heads to a lifeguard for first aid for the bluebottle sting.
The helpful young man gives her ice to hold on the welts that have appeared, but that doesn't help. At least he didn't try vinegar.
That would have made matters worse according to poison information specialist Leo Schep.
"Don't use vinegar, because that will just make it release more of the venom," he says.
New studies show that the best treatment is to wash the site with seawater or fresh water to get rid of the stinger.
"If you've got pain, you can immerse your hand or wherever you've been stung in hot water and that will denature the venom."
Schep explains that denaturing changes the structure of the venom, which is a protein. Hot water does that in much the same way as cooking an egg white.
This treatment information comes from a new report for doctors on how to treat bites, stings and jabs from New Zealand's venomous creatures.
Schep, along with Robin Slaughter, Michael Beasley and Bruce Lambie have updated information using the latest studies. It makes for mostly comforting reading.
"Of the numerous jellyfish within New Zealand's coastal waters, only two species (within the same genus) are considered medically important," their report says.
They are the bluebottle (Physalia utriculus) and the Pacific or Portuguese man-of-war (Physalia physalis).
"The two jellyfish most dangerous to humans, the box jellyfish (Chironex fleckeri) and irukandji jellyfish (Carukia barnesi), are not found in New Zealand."
Bluebottles have a distinctive bright blue floating bladder, like a little plastic bag, and one main deep-blue fishing tentacle. This long, trailing thread may be up to 10 metres long.
The man-of-war is larger, has the same blue bladder and up to five main tentacles. These two jellyfish have stinging cells called nematocysts, which can penetrate human skin. If that happens, people need to take it quietly.
"Initially, the victim should be prevented from rubbing the area or performing vigorous muscular activity, as this will lead to greater discharge of attached nematocysts and venom movement into general circulation."
STINGRAY ATTACK
So if you're stung, don't keep swimming or surfing - head for a hot shower. That's also the recommended treatment for fish stings, including a jab from a stingray.
"Hot water immersion can be of considerable benefit and should be trialled at an optimum temperature of around 45 degrees Celsius for 15 to 20 minutes, taking care not to cause a thermal burn," the report says.
However, stingray attacks can be fatal, as we know from the death of crocodile hunter Steve Irwin in 2006, so people need to seek medical attention - swiftly, if there's a chance an internal organ or major blood vessel has been pierced.
Schep says that if a person is stabbed in the limb by a stingray, the hot water will help neutralise the pain.
"But you will need to see a doctor to make sure the wound is clear of any of the barbs that may be left behind," he says.
Not only do these barbs contain venom, they may also introduce a range of marine bacteria to the wound, or the spine may break and contaminate the site.
Other venomous fish to watch out for in our seas are the scorpion fish, spiny dogfish and elephant fish. In freshwater, the brown bullhead catfish also has nasty spines. Once again, good old hot water is the favoured treatment, but people need to make sure there are no barbs left.
That's also the biggest problem with kina, Schep says.
"They're not venomous, but spikes can break off and remain in the wounds, so we advise that if you've been spiked by one, perhaps get it check by a doctor."
BITING WORRIES
Now we're on to the biters - spiders and snakes. New Zealand has none of the latter on land, but occasionally a sea snake might beach itself in Northland.
If you see either a yellow-bellied sea snake (Pelamis platurus) or a banded or yellow-lipped sea krait (Laticauda colubrine) lying on the sand up north, don't try picking it up.
"There have been no recorded bites from these and if you are bitten, you need prompt medical attention because what it does is break down the muscles in the body and causes complications with your kidneys."
Schep says there is anti-venom available in Auckland Hospital.
Finally, spiders. Only three get a mention in the report - katipo, redbacks and white-tailed spiders.
The first two are from the Latrodectus family and are venomous, but there have only been two reported deaths from katipo. They were back in the 1800s and both victims were children, Schep says.
Redbacks are Australian imports and have only been known in New Zealand since the 1980s. They are found around Central Otago. There have also been reports of these spiders in New Plymouth. Anti-venom is available to treat bites from both these spiders.
Finally, we are on to the infamous white-tailed spider and a new study from across the ditch. This shows once and for all that this aggressive spider does not deserve the bad rap it gets.
"The white tail is not venomous at all," Schep says.
They do hurt when they bite and people can get a secondary infection, but that's as bad as it gets.
"A recent study has demonstrated that there is no link between white-tailed spider bites and tissue necrosis," the New Zealand report says.
It says the Australian study looked at 130 cases and only included patients with a clear history of a bite where the spider was caught at the time and later identified by an arachnid expert. None of these people developed necrotic (flesh-eating) ulcers.
"Indeed, the only spiders proven to cause necrotising arachnidism belong to the genus Loxosceles, such as the North American brown recluse spider, and are not found in New Zealand," the report says.
There you have it: Head to hot water for bluebottles, the doctor when barbs are involved, the hospital (Auckland is best) if you get in the way of a stranded sea snake and know there's anti-venom available for a katipo or redback bite. But don't be so frightened of those spiders with white tails - just be sensible.
"Any puncture wound can get infected," Schep says.
Venomous first aid - wellbeing - life-style | Stuff.co.nz
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