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:

  • Pressure Immobilisation Technique/Bandage
  • Vinegar
  • Cold compress
  • Heat therapy

So, let’s dive into each of the four treatments and see how to apply them to the applicable creatures that cause the dramas!

Pressure Immobilisation Technique

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:

  • Paralysis
  • Interference with blood clotting
  • Pain
  • Muscle and tissue breakdown
  • Effects on the cardiovascular system (heart/lungs)

Funnel Web Spider

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:

  • Pain
  • Numbness around the mouth
  • Spasms of the tongue
  • Nausea and vomiting
  • Abdominal pain
  • Profuse sweating
  • Salivation
  • Lacrimation (tears from eyes)
  • Piloerection (goose-bumps)

Blue Ringed Octopus

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:

  • A puncture mark, possibly with a touch of blood, painless
  • Tingling around the mouth
  • Nausea and vomiting
  • Progressive weakening of the muscles, especially respiratory muscles, leading to slowing or stopping of breathing.

Cone Shell

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:

  • A puncture mark, possibly with a touch of blood, painless
  • Tingling around the mouth
  • Nausea and vomiting
  • Progressive weakening of the muscles, especially respiratory muscles, leading to slowing or stopping of breathing.

First Aid Treatment

Always remember DRSABCD! Specific Pressure Immobilisation Technique is as follows:

  1. Stop all movement, lay the patient down and encourage them not to move
  2. If bite is on the limb, apply a bandage firmly from just above the fingers/toes up to the armpit/groin. If bite is on the torso, apply firm pressure using a broad pad.
    • An alternate bandage technique is to apply a bandage directly over the bite site. Then bandage from the fingers/toes to armpit/groin.

     

  3. Using a pen, mark on the bandage where the bite is.
  4. Immobilise the limb by splint or sling.
  5. Have help come to the patient, do not move them.

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.

Things not to do…

  • DO NOT cut the bite site
  • DO NOT suck the venom out
  • DO NOT wash the bite site – a swab of the bite site can be taken and the venom can be tested using a venom detection kit. If washed, this can’t happen.
  • DO NOT use a tourniquet
  • DO NOT move the casualty
  • DO NOT catch the snake to identify it – this can be done using a venom detection kit

Snake Venom Detection Kit – Australia is the only country that can do this!

Vinegar

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

Chironex Fleckeri – Box Jellyfish – Sea Wasp

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:

  • Sudden onset excruciating pain, described as being ‘hit with a whip’
  • Tissue necrosis (death of tissue)
  • Cardiac and respiratory function can be severely affected, and quite rapidly

What it looks like following envenomation by a Box Jellyfish

Jellyfish causing Irukandji Syndrome

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:

  • Initial minor sting at the site of tentacle contact, most times without visually seeing the tentacle
  • Severe generalised pain follows in 5 – 40 minutes, cramping in nature, but can be worse in the lower back/abdominal region
  • Nausea and vomiting
  • Difficulty breathing
  • Sweating
  • Restlessness
  • Feeling of ‘impending’ doom

First Aid Treatment

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.

Cold Compress

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.

Redback Spider

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:

  • Immediate pain at bite site, becoming hot, red and swollen
  • Intense local pain which may increase and spread
  • Nausea, vomiting and abdominal pain
  • Localised sweating at the bite site
  • Swollen glands in the armpit or groin of the limb where the bite occurs.

It is very rare that anti-venom is required, however it is available should it be needed.

All other Australian spiders

Including the White Tailed Spider, Mouse Spider and Huntsman Spider, you use cold compress.

Bees, wasps, ants, ticks

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

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!

Blue Bottle Jellyfish

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:

  • Localised immediate pain, may spread to lymph nodes in armpits/groin, depending on where sting occurs
  • Skin lesions (appear like a ‘string of beads’)
  • Treat by removing the tentacles, preferably with forceps
  • Soak affected limb in hot water, as hot as the casualty can tolerate
  • If unrelieved, consider using ice-packs
  • Call Triple Zero if pain is intolerable, if sensitive areas are stung (e.g. eyes) or if larger areas are affected

Stonefish

All you need to know is here – https://www.paradisefirstaid.com.au/stone-fish-first-aid/

All other fish including flathead, stingray, sea urchin, male platypus, etc. will have the following signs and symptoms, which include:

  • Intense pain that can lead to irrational behaviour
  • Swelling
  • Sometimes a blue/grey colour around the wound
  • Bleeding

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.

Antivenom

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.

Snakes (Tiger, Brown, Taipan, Black, Death Adder,Sea snake, polyvalent) Horse
Funnel Web Rabbits
Redback Horses
Box Jellyfish Sheep
Paralysis Tick Dogs
Stonefish Horses

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!

Quick Reference Table

Treatment Animals
Pressure Immobilisation Technique All venomous snakes including sea snake
Funnel Web Spider
Cone Shell
Blue Ringed Octopus
Vinegar THINK TROPICAL JELLYFISH
Box Jellyfish
Jellyfish causing Irukandji Syndrome
Cold Compress Bees
Wasps
Hornets
Ticks
Ants
All other spiders such as Redback, White Tail, Huntsman, etc
Heat Therapy THINK NON-TROPICAL JELLYFISH
Blue Bottle Jellyfish
Stingray
Stonefish
Bullrout
Male Platypus
Sea urchin
Any fish with spines
Craig Middleton
About Craig Middleton
Craig is the company' Training Manager and has been at Paradise First Aid since 2016. Craig spent most of his adult life putting out fires and cutting cars up as a firefighter. In his spare time, he could be found jumping off cliffs, searching and rescuing people out of the bush, driving boats in floodwater and climbing on roofs after storms as a volunteer with the SES. Craig left the fire and rescue arena to do a Bachelor of Paramedic Science, graduating with Distinction, coming on board as a trainer and assessor part way through his degree.

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