Salim Al-Jabri

1. Hazardous marine creature in Oman DR.Salim AL-Jabri R1

2. Introduction 2000 species are venomous or poisoning to human Many can produce sever illness and fatilties Number of victims increase Most marine injure human with defence and food –procuring devices

3. VenoumsMarine Animals Three main classes according to mechanism of venom delivery; 1- Nematocysts 2- Bites 3- Stings

5. E.g ; - Portuguese man-of-war - True jellyfish - fire corals - stinging hydroids - sew wasp,,, boxjellyfish - sea nettle & anemones

7. Basic mechanism is ‘spring –loaded’ venom gland

8. mechanical or chemical stimulation

10. Tentacles can be up to 100 feet in somegaint species

11. Can still function even after animale is dead or tentacles are seprated

12. stinging cell can remain active for weeks

15. Intensity increasing over 10 minutes.

16. Erythema.

17. Pruritus.

18. Papules, vesicles, pustules & Necrotic ulcers.

19. Increase oral secretions.

20. Gastrointestinal disturbance.

21. Muscle spasm.

23. Symptoms tentacles which inject the poison become sticky and adhere tightly to the skin venom of box jellyfish has cardiotoxic, neurotoxic and highly dermatonecrotic components

24. In oman Batinah coast and far east like Sur Jun , July and August 75 cases were reported in koula hospital between 1991-1992 mild – moderate cases , no death

26. Immobilize the limbs

27. Apply generous amounts of vinegar( acetic acid) which will disables the box jelly's nematocysts that have not yet discharged into the bloodstream

30. Ensure that the seawater is free of jellyfish or even fragments of tentacles because they remain toxic for months.

32. Oral antihistamines and narcotics for pain control are occasionally warranted.

33. Antibiotics should be considered for vesicular lesions to prevent secondary infection.

34. Muscle spasms can be treated with 10 mL of calcium gluconate of a 10% solution intravenously .

36. Bites Sharks Octopi

37. Sharks

38. Sharks About 350 species of sharks, only 30 species could potentially be dangerous to humans and only 12 are reported potentially aggressive and dangerous Most dangerous to human; - Great white -Tiger shark -Bull shark

39. Symptoms & signs Severe bleeding, injury to or excision of muscle & bone

40. Treatment Control any visible bleeding by applying direct pressure. Keep the victim calm. Provide warmth, since the victim may be chilled from the water and may be suffering from hypothermia Transfer the pt. To the hospital

42. Octopus - blue –ringed - bitten in upper extremities - modified salivary gland - venom into the wound - vasodilator and inhibitor of neuromuscular transmission

43. Symptoms initial bite is not painful weakness and numbness nausea and vomiting. Severe envenomations may progress rapidly to generalised flaccid paralysis and respiratory failure Death may occur in as little as thirty minutes.

44. Treatmnet Reassure the patient and encourage them to remain calm . Pressure-immobilisation first aid is recommended No antivenin supportive respiratory support is most important lifesaving intervention

46. cone shells

47. bristal warm

48. sea snakes

49. stingrays

50. scorpion fish

53. Purplish discoloration.

54. Edema and swelling.

55. Partial paralysis of a limb.

56. Facial swelling.

57. Muscle spasm.

58. Dyspnea.

59. Weakness.

61. treatment Most wounds heal in about one month. spines have penetrated a joint or nerve, see a doctor wound shows any sign of infection, such as redness, warmth, or pus formation. Victims with generalized weakness, shortness of breath, and/or nausea and vomiting after a puncture should go directly to an emergency facility

62. Cone shells Much more toxic than sea urchins Tubular gland connect to several teeth at the retractable proboscis venom conetinesevralprotiens ; - 3-indolyl derivatives which act on skeletal muscle & cause variably spastic and flaccid paralysis

64. pain

65. Nausea and general purities

66. diplopia

67. slurred speech

68. numbness

69. weakness

70. Paralysis

72. Stingray

73. Shallow, sandy areas to deep oceans Tail with poisonous barb near base of body. Sting are often broken or left in the wound

74. Symptoms Lacerations & severe pain. Punctures in abdomen or chest are very serious. Anorexia, Nausea and vomiting. Diarrhea, increase micturition & salivation. Muscle cramping, tremor & tonic paralysis. Convulsions. Cardiac abnormalities to include asystole. Hypotension. Respiratory depression. Ulceration and necrosis & Infection.

76. First aid Lay the person down If the person is vomiting, position the person on the side so they do not inhale vomit. Stop the bleeding by applying direct pressure with a clean cloth or whatever is available such as a beach towel. You may attempt to remove the stinger with tweezers to decrease toxinexposure if doing so will not cause further injury. Be careful not to injure yourself with the stinger.

77. First aid If there is no pain, then treat as a puncture wound or laceration by cleaning and disinfecting with soap and water. faintness or sweating (which indicate that venom has been absorbed into the body), arrange for transportation to a medical facility

79. Pain medication, such as narcotics

81. Tetanus

82. Antibiotics are usually given because the wound is contaminated with bacteria from the stinger and from the seawater

83. wound is left open, then closed with stitches a few days later if it has not become infected

85. Prevantion When wading in shallow waters where stingrays may be, wear foot protection and shuffle your feet to scare away any resting rays

86. Sea Snakes

87. Symptoms Mild Euphoria. Anxiety. Restlessness. Thirst. Swelling of tongue. Nausea & vomiting. Weakness. Stiffness & Muscle ache Severe Paralysis (ascending or spreading from bite). Trismus. Ptosis. Facial & ocular palsies. Speech & swallowing pathology. Respiratory distress. Cardiac failure. Convulsions. Coma.

90. Immobilize the limb.

91. Local excisions and suction should be avoided.

92. Monitor for any cardiac, pulmonary, renal, fluid, and electrolyte abnormalities.

94. Sea snake venom should be used cautiously & administered in strict accordance to guidelines.

95. Preparation for anaphylaxic shock should be immediately available.

96. If land snake antivenom is to be used, then the tiger snake type is preferred.

98. Stonefish

99. Stonefish Glands at the base of their needle-like dorsal fin spines Most venomous fish known Exactly like an encrusted rock Severity of the symptoms depends on the depth of penetration and the number of spines involved

100. Stonefish pain Tremendous swelling rapidly develops with death of tissues Muscle weakness Temporary paralysis Shock

102. First AId Remove pieces of spines encouraging bleeding might remove some venom wash with water. Rest and elevate immerse wound in hot water (45 C or 113 F) for 30-90 minutes or until pain decreases elevate and dress with something clean.

103. Mangment Local analgsia IV narcotic analgesia, local anaesthetic infiltration or regional block may be required antivenom ; 1-the victim suffers from severe pain 2-systematic symptoms like weakness and paralysis are observed 3-there are multiple punctures, which indicate the discharge of several spines. This means that larger amount of venom has been injected.

105. Important points  Be prepared for cardiopulmonary collapse even in what appears to be a minor envenomation.  Be prepared for anaphylactic reactions.  When culturing wounds, inform the laboratory that the injury was in a marine environment. Factors, such as salt concentration of the media, incubation temperatures, and time, need to be adjusted.

106. Important points  consider antibiotics  Tetanus injuction

107. thanks