G’day everyone and welcome to another blog. This one is going to give a broad outline on what to do for all the awesome things out there in this fantastic country of ours that can bite, sting or envenomate us!!! There have been a couple of blogs and guides done up in the past on our site, but I figured that this one will put it all in the one spot. To make it a bit easier, I will divide the blog up into the four treatment categories, then add in some of the animals/creatures into each category. Please note, this is not intended to be an exhaustive list of all creatures and subsequent treatments. I will, however, like to give a big recommendation to all of you to download the excellent Australian Bites and Stings app from your app store. The four treatments we use for dealing with bites, stings and envenomation’s are:
So, let’s dive into each of the four treatments and see how to apply them to the applicable creatures that cause the dramas!
The four animals we treat with the pressure immobilisation technique are:
All venomous snakes (including sea snakes)
Snakebite venom acts on the body in a number of different ways, depending on the snake that bites you. Affecting many systems in the body, venoms can be neurotoxic (paralysing), pro-coagulant (clot the blood), anti-coagulant (thin the blood), weak cytotoxic (muscle damaging) properties. Some venoms are also show potent myotoxic (muscle damaging) properties. When bitten, the venom of the snake goes into the lymphatic system which will then, in time, make its way into the circulatory system. Common signs and symptoms of snake bite envenomation include:
This delightful looking spider, commonly referred to as ‘The Sydney Funnel Web’ actually isn’t isolated just in Sydney. Granted, the species around Sydney has proved to have caused the most fatalities, but there are a number of other species of Funnel Web who range north to Queensland, south to Tasmania and west to South Australia. Not a lot is known about the venom of the Funnel Web, nor its toxicity on humans. When they bite, in most cases very little venom is injected. However, all bites should be treated with the pressure immobilisation technique. There has also been some evidence showing that prolonged immobilisation can lead to inactivation of the venom. Signs and symptoms can occur quite rapidly if effective first aid is not performed and include:
One of the oceans most lethal creatures, this beautiful little octopus shouldn’t be feared as it is a very shy creature and, although very common in Australian waters, is seldom encountered. They don’t go out of their way to attack humans and will only bite if they are handled. So… Don’t pick them up!!! They are between 10 – 20cm from tentacle tip to tip and are a yellowish-brown colour. The blue rings only show when they are agitated. The bite of the Blue Ringed Octopus is painless. If unaware, you will only really know about it when the signs and symptoms start showing. The toxin released is a very powerful neurotoxin resulting in paralysis, especially to the respiratory muscles. The effects can be quite rapid. There is no known anti-venom for a Blue Ringed Octopus bite. Signs and symptoms can include:
The Cone Shell, also known as the Cone Snail, is another very venomous sea creature. But as with the Blue Ringed Octopus, this critter isn’t known to go out of its way to give us a hard time, only envenomating humans when handled. Of the several hundred varieties of Cone Shell, only a very small handful are known to be hazardous to humans. With no anti-venom available, the toxin of the Cone Shell is a concoction of hundreds of different toxins which cause similar signs and symptoms to the Blue Ringed Octopus. Signs and symptoms can include:
Always remember DRSABCD! Specific Pressure Immobilisation Technique is as follows:
The bandage should be tight enough so that it is difficult to slide a finger between the bandage and skin.
From left – Setopress or similar snake bite bandage is best, followed by heavy elastic bandage, followed by normal crepe bandage. If no bandages are available, improvise and use clothing.
 Snake Venom Detection Kit – Australia is the only country that can do this!
There are two lots of critters that we treat using vinegar – the Box Jellyfish and jellyfish causing Irukandji Syndrome. Both are found in tropical waters of Australia
The Box Jellyfish, when it stings you, can be fatal. The tentacles, ranging in length up to 3m, are bunched on each of the four ‘corners’ of the Box Jellyfishes body, or bell. These tentacles contain millions of little cells called nematocysts. These nematocysts look like a little coiled up spring in a capsule. When the capsule hits flesh, the spring in the capsule is released and the venom contained in the nematocyst is released into the fish, prawn or, unfortunately, the human swimming in the water! There appear to be multiple components to the venom, however as it is extremely difficult to collect the venom, little is known definitively about the composition. Signs and symptoms of Box Jellyfish envenomation are:
What it looks like following envenomation by a Box Jellyfish
So why not just the one Irukandji Jellyfish? There are actually a number of jellyfish that, collectively when they sting, have similar signs and symptoms known as Irukandji Syndrome. So it’s not just one jellyfish that causes the nastiness. Not a great deal is known about these jellyfish. They are small, between 5 – 25mm, their tentacles can grow anywhere up to 1m long. As with the Box Jellyfish, they sit on the ‘corners’ of the bell, but in this case, there is only one tentacle per corner. It is also thought that in addition to stingers in the tentacles, they also have stingers on the bell. Signs and symptoms of Irukandji Syndrome can include the following:
As always, remember DRSABCD. The basic life support flowchart always takes priority. The treatment for any tropical jellyfish sting is to simply douse it with liberal amounts of vinegar. This does nothing for the venom already inside the patient, however it does neutralise the existing nematocysts on the tentacles still attached, thus rendering them safe to you the first aider and to your patient. You may also need to perform CPR as there is a high chance, particularly for Box Jellyfish, that your patient will go into cardiac arrest. It is imperative that an ambulance is called quickly so that anti-venom can be administered.
When teaching first aid courses, I generally say that anything that is on the land that stings or bites you (other than those treated with the PIT), apply a cold compress, which is simply a wrapped bag of ice or wrapped instant ice pack. The following are animals/critters that you will use a cold compress for.
Found throughout Australia, they like to build webs underneath things, such as underneath shelves, chairs, toilet seats, cars, etc. Containing a number of components in the venom, mainly protein based, signs and symptoms of a Redback Spider bite include:
It is very rare that anti-venom is required, however it is available should it be needed.
Including the White Tailed Spider, Mouse Spider and Huntsman Spider, you use cold compress.
All are treated with a cold compress. The immediate signs and symptoms will be intense localised pain and swelling. However, some people may have a severe allergic reaction, so must be treated accordingly with their EpiPen.
Heat therapy we use for marine stings/envenomation, so long as it is not a tropical jellyfish (see above) or a Cone Shell or Blue Ringed Octopus (see above). One that is commonly confused with is the Blue Bottle Jellyfish, so we’ll start there!
Also known as the Portuguese Man-O-War, this jellyfish is common around Australia. The float can be between 2-15cm across and the tentacles can reach 10m in length. These tentacles contain nematocysts as described earlier, however if vinegar is applied, it can actually cause more nematocysts to discharge, so is not recommended. Signs and symptoms and treatment:
All other fish including flathead, stingray, sea urchin, male platypus, etc. will have the following signs and symptoms, which include:
Treatment is soaking the effected limb in hot water, as hot as the patient can tolerate. If the barb or spine is still in the limb, treat as if it were a penetrating object. Call Triple Zero if applicable.
Before finishing up, I want to share a quick insight into antivenom and how it’s made. Basically, antivenoms are purified antibodies against the venom itself, or components of the venom. The venom is either milked from the animal (such as snakes and the Funnel Web) or extracted by dissection (such as with Redback spider, Stonefish and Box Jellyfish). Small doses of this venom are injected into a host animal, which gradually builds up a tolerance to the venom. The animal then produces antibodies in response to the venom being introduced. The blood of the animal is harvested and the antibodies are subsequently separated. The below table shows which animal the antivenom is produced in.
And that folks pretty much wraps it all up. Although this goes into a lot more depth than what is covered in your standard Provide First Aid course that we offer at our three training locations, it is still a great idea to come along and get hands on training, particularly with the application of the Pressure Immobilisation Technique. Please jump on to our website – https://www.paradisefirstaid.com.au/ – to book in your next first aid course or give us a call in our head office on 07 5572 5299. Thanks for reading and I hope this blog is helpful. Stay safe!
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