![]() ![]() You may think you would see every fish, especially the ones that are big enough to be dangerous. Because coral growth takes years or decades to grow and when you stand it dies. Now you know that you should keep distance from fish and coral. Previously I have written about the dangerous species of fish commonly found in the Maldives and this post is not going to cover all the fish. I have heard in some resorts they advise tourists to keep two arms distance, which comes to around 6 feet for an average person. A clinician’s guide to Australian venomous bites and stings: Incorporating the updated CSL antivenom handbook.I always advice my guests to keep 6 feet from any sea creature. Stonefish envenomation presenting to a Singapore hospital. Annals of the Academy of Medicine Singapore 2004 33:515-520 #STONE FISH SERIES#A series of 8 cases and review of the literature. Stonefish envenomation of the hand – a local marine hazard. All patients should be warned about the risk of infection and to look for signs of secondary infection.If requiring IV opiates or antivenom the patient should be observed for four hours to see if they remain asymptomatic.If there are no signs of systemic envenomation by two hours the patient can be discharged.Give 1 ampoule for every two spine puncture wounds to a maximum of 3 ampoules, undiluted IM injection or diluted in 100ml of 0.9% saline IV over 20 minutes (we do not know whether it is best to give the antivenom IV or IM).CSL stonefish antivenom is used if the patient is refractory to IV opioid analgesia, regional block or has features of systemic envenomation.May require an X-ray or ultrasound to look for a retained foreign body.The use of antibiotics is controversial but there is potential risk of a marine infection, a discussion with the patient re: observation or prophylactic antibiotics would be reasonable. #STONE FISH SKIN#If you have anaesthetised the skin and are still using hot water therapy – make sure there is another limb in the water to make sure you are not causing secondary burns. Other strategies may involve regional blocks with a long acting anaesthetic.
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