Stingray Envenomation Workup

  • Author: John L Meade, MD; Chief Editor: Scott H Plantz, MD, FAAEM   more...
 
Updated: Mar 2, 2012
 

Laboratory Studies

No laboratory studies are indicated in the usual case of stingray injury.

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Imaging Studies

Plain radiography should generally be used to obtain images of the injured area in at least 2 planes. Plain radiography is useful to rule out the presence of any foreign bodies, such as retained components of the barb mechanism, as well as to differentiate injuries caused by some other object (eg, sharp object stepped on in the water, causing a retained foreign body).

A stingray barb is shown in the radiograph below.

Stingray barb broken off in ring finger. Photo by Stingray barb broken off in ring finger. Photo by John L. Meade, MD.
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Contributor Information and Disclosures
Author

John L Meade, MD  CEO, Statdoc Consulting, Inc; Medical Director and Member, South Baldwin (AL) SRT (SWAT); Medical Director, Multiple EMS Agencies

John L Meade, MD is a member of the following medical societies: American College of Emergency Physicians and Medical Association of the State of Alabama

Disclosure: Nothing to disclose.

Specialty Editor Board

Richard S Krause, MD  Senior Clinical Faculty/Clinical Assistant Professor, Department of Emergency Medicine, University of Buffalo State University of New York School of Medicine and Biomedical Sciences

Richard S Krause, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Emergency Physicians, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

John T VanDeVoort, PharmD  Regional Director of Pharmacy, Sacred Heart and St Joseph's Hospitals

John T VanDeVoort, PharmD is a member of the following medical societies: American Society of Health-System Pharmacists

Disclosure: Nothing to disclose.

Richard H Sinert, DO  Professor of Emergency Medicine, Clinical Assistant Professor of Medicine, Research Director, State University of New York College of Medicine; Consulting Staff, Department of Emergency Medicine, Kings County Hospital Center

Richard H Sinert, DO is a member of the following medical societies: American College of Physicians and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

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.

References
  1. de Haro L, Pommier P. Envenomation: a real risk of keeping exotic house pets. Vet Hum Toxicol. Aug 2003;45(4):214-6. [Medline].

  2. Fenner PJ, Williamson JA, Skinner RA. Fatal and non-fatal stingray envenomation. Med J Aust. Dec 4-18 1989;151(11-12):621-5. [Medline].

  3. Perkins RA, Morgan SS. Poisoning, envenomation, and trauma from marine creatures. Am Fam Physician. Feb 15 2004;69(4):885-90. [Medline].

  4. Clark RF, Girard RH, Rao D, Ly BT, Davis DP. Stingray envenomation: a retrospective review of clinical presentation and treatment in 119 cases. J Emerg Med. Jul 2007;33(1):33-7. [Medline].

  5. Campbell J, Grenon M, You CK. Pseudoaneurysm of the superficial femoral artery resulting from stingray envenomation. Ann Vasc Surg. Mar 2003;17(2):217-20. [Medline].

  6. Ellenhorn MJ. Envenomations: bites and stings. In: Ellenhorn's Medical Toxicology. Lippincott Williams & Wilkins; 1997:1737-98.

  7. Guenin DG, Auerbach PS. Trauma and envenomations from marine fauna. In: Tintinalli JE, et al, eds. Emergency Medicine: A Comprehensive Study Guide. McGraw-Hill; 1996:868-73.

  8. Otten EJ. Venomous animal injuries. In: Rosen P, et al, eds. Emergency Medicine: Concepts and Clinical Practice. Mosby-Year Book; 1998:924-40.

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Typical stingray puncture wound on a foot, approximately 60 minutes after injury. Photo by John L. Meade, MD.
Stingray barb in forearm. Photo by John L. Meade, MD.
Stingray barb broken off in ring finger. Photo by John L. Meade, MD.
Spine removed from stingray injury. Image courtesy of Scott Plantz, MD.
Stingray.
Stingray.
 
 
 
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