 |
| Serpent starfish (Ophiolepsis sp.) |
15 years old boy was brought to
casualty by bystander after stung by serpent starfish at his right forearm
while swimming in Lahad Datu Coastal region. He develops severe intense burning
pain at the stung area. Vital signs are normal and no evidence of anaphylaxis.
He was treated with hot water immersion at the temperature of 45 degree celcius
for 20 minutes. However, intravenous weak opiod was given as he could not
tolerate the pain. He was discharged well after three hours of observation in
casualty.
.
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| Tourniquet is un necessary first aid method and not proven to be beneficial. |
Examination
of the hand showed lashes mark at the postero medial aspect of distal
right forearm region associated with redness, warm and local swelling.
No active bleeding noted and range of movement of wrist joint was intact
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Discussion
Serpent starfish (Ophiolepsis sp.) is classified under
phyllum echinoderm together with starfish, sea urchins, sea cucumbers, crinoids
(sea lilies) and sand dollars. Serpent starfish use their flexible arms for
locomotion and crawls across the sea floor. This five long slender, whip like
arms' creature is a nocturnal detritivore.
This organism rarely causing severe
anaphylaxis but the heat labile sting may cause severe pain and uneasiness to
the patient.
Management for the sting includes
hot water immersion temperature 43-45 degree Celsius for 20 minutes followed by
10-15 minutes rest then repeated for 2 hours. This technique is usually
adequate to alleviate the pain. However, some patient may need intravenous pain
killer including opiod. Although rare, patient should also be looked for sign
and symptoms of anaphylaxis. Anti histsmine, steroids are not proven beneficial
but may be used to treat symptoms of itchiness or urticaria. IM Adrenaline
should be started if patient develops sign of anaphylaxis.
.png) |
| Immersion in hot water can alleviate the pain causing by this heat labile sting |
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