eMedicine Specialties > Emergency Medicine > Environmental

Octopus Envenomation: Follow-up

Author: Jon Mark Hirshon, MD, MPH, Associate Professor, Department of Emergency Medicine, University of Maryland School of Medicine
Contributor Information and Disclosures

Updated: Aug 14, 2008

Follow-up

Further Inpatient Care

  • The patient with octopus envenomation should be admitted to an intensive care unit until the venom has worn off, usually in 4-10 hours.
  • If significant hypoxia has not occurred, recovery is usually rapid.

Further Outpatient Care

  • Local wound care follow up is prudent.

Complications

  • If acute paralysis and respiratory arrest is not immediately recognized and appropriately treated, anoxic brain injury or death will result.

Prognosis

  • The prognosis for octopus envenomation is generally excellent, unless significant hypoxia has occurred.
  • Patients should be warned that anaphylactic reactions may result in ongoing symptoms (eg, joint pains, effusions) for up to several weeks.

Patient Education

  • Individuals in Australian coastal waters must be educated to take care where they step in tide pools and not to pick up an octopus.
  • For excellent patient education resources, visit eMedicine's Bites and Stings Center. Also, see eMedicine's patient education article
    Stingray Injury.

Miscellaneous

Medicolegal Pitfalls

  • The main pitfall is failure to recognize the patient's inability to maintain a patent airway and adequate respirations, leading to a failure to provide airway support and supportive treatment until the toxin has worn off.
 


More on Octopus Envenomation

Overview: Octopus Envenomation
Differential Diagnoses & Workup: Octopus Envenomation
Treatment & Medication: Octopus Envenomation
Follow-up: Octopus Envenomation
Multimedia: Octopus Envenomation
References
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References

  1. Auerbach PS. Marine envenomations. N Engl J Med. Aug 15 1991;325(7):486-93. [Medline].

  2. Chang FCT, Spriggs DL, Benton BJ, et al. 4-Aminopyridine reverses saxitoxin (STX)- and tetrodotoxin (TTX)- induced cardiorespiratory depression in chronically instrumented guinea pigs. Fundam Appl Toxicol. Jul 1997;38(1):75-88. [Medline].

  3. Flachsenberger WA. Respiratory failure and lethal hypotension due to blue-ringed octopus and tetrodotoxin envenomation observed and counteracted in animal models. J Toxicol Clin Toxicol. 1986-87;24(6):485-502. [Medline].

  4. Kizer KW. Marine envenomations. J Toxicol Clin Toxicol. 1983-84;21(4-5):527-55. [Medline].

  5. McGoldrick J, Marx JA. Marine envenomations. Part 2: Invertebrates. J Emerg Med. Jan-Feb 1992;10(1):71-7. [Medline].

  6. Nimorakiotakis B, Winkel KD. Marine envenomations. Part 2--Other marine envenomations. Aust Fam Physician. Dec 2003;32(12):975-9. [Medline].

  7. Oda K, Araki K, Totoki T, et al. Nerve conduction study of human tetrodotoxication. Neurology. May 1989;39(5):743-5. [Medline].

  8. Walker DG. Survival after severe envenomation by the blue-ringed octopus (Hapalochlaena maculosa). Med J Aust. Dec 10-24 1983;2(12):663-5. [Medline].

  9. Watters MR, Stommel EW. Marine Neurotoxins: Envenomations and Contact Toxins. Curr Treat Options Neurol. Mar 2004;6(2):115-123. [Medline].

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Further Reading

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Keywords

octopus envenomation, octopus poisoning, octopus bite, blue-ringed octopus envenomation, Hapalochlaena lunulata envenomation, Hapalochlaena maculosa envenomation, Cephalopoda, Mollusca

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Contributor Information and Disclosures

Author

Jon Mark Hirshon, MD, MPH, Associate Professor, Department of Emergency Medicine, University of Maryland School of Medicine
Jon Mark Hirshon, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Emergency Physicians, American Public Health Association, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Medical Editor

Dana A Stearns, MD, Assistant Director of Undergraduate Education, Department of Emergency Medicine, Massachusetts General Hospital
Dana A Stearns, MD is a member of the following medical societies: American Academy of Emergency Medicine and American College of Emergency Physicians
Disclosure: Nothing to disclose.

Pharmacy Editor

John T VanDeVoort, PharmD, ABAT, Director of Pharmacy, Sacred Heart Hospital
John T VanDeVoort, PharmD, ABAT is a member of the following medical societies: American Academy of Clinical Toxicology and American Society of Health-System Pharmacists
Disclosure: Nothing to disclose.

Managing Editor

James Steven Walker, DO, MS, Clinical Professor of Surgery, Department of Surgery, University of Oklahoma Health Sciences Center
James Steven Walker, DO, MS is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, American College of Osteopathic Emergency Physicians, and American Osteopathic Association
Disclosure: Nothing to disclose.

CME Editor

John D Halamka, MD, MS, Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center
John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Chief Editor

Scott H Plantz, MD, FAAEM, Associate Clinical Professor of Emergency Medicine, Rosalind Franklin University of Medicine and Science, Chicago Medical School; Medical Director, WeCare Med,Inc
Scott H Plantz, MD, FAAEM is a member of the following medical societies: American Academy of Emergency Medicine
Disclosure: Nothing to disclose.

 
 
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