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Scuba Diving: Starfish (Sea Star) and Crown of Thorns Puncture Wounds

Medical Author:
Scott D. Fell, DO, FAAEM
Medical Editor:
Charles Patrick Davis, MD, PhD

Starfish (Sea Star) and Crown of Thorns Puncture Wounds Facts

  • Starfish, crown of thorns, and sea stars are marine animals of the class Asteroidea, and live throughout the subtropics and tropics.
  • They are bottom dwellers, so any contact with a diver is usually accidental.
  • Injury occurs from the spine and the venom in a gelatinous form from around the spine areas.
  • It can be injected into the skin and even through gloves as some star fish have long spines.
  • Crown of thorns have as many as 13 to 16 short, sharp spines that are up to 6 cm (over 2 inches) long.
  • Starfish (also termed sea stars) vary from about 1 inch to about 3 ft. in diameter.

Starfish (Sea Star) and Crown of Thorns Puncture Wounds Symptoms

  • After the skin puncture, the victim experiences severe and immediate pain, significant bleeding and swelling at the site.
  • Symptoms are usually limited, lasting from 30 minutes to 3 hours and then resolving.
  • More severe reactions or envenomations can include numbness, tingling, weakness, nausea, vomiting, joint aches, headaches, cough, and in rare cases paralysis.
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Starfish (Sea Star) and Crown of Thorns Puncture Wounds Treatment

If medical attention is not readily available, the following guidelines are recommended in treating a puncture wound:

  • Immerse the affected area in water as hot as the person can tolerate for 30 to 90 minutes. Repeat as necessary to control pain (water temperature should not exceed 140 F or 60 C).
  • Some stings may require an injected local anesthetic for pain relief.
  • Use tweezers to remove any spines in the wound because symptoms may not resolve until all spines have been removed. Occasionally the spines may remain in the wound, and will require a health care professional to remove them. Scrub the wound with soap and water followed by extensive rinsing with fresh water.
  • Do not cover the wound with tape or any other type of occlusive dressing as it may increase the risk of an infection. A tetanus booster is often recommended for patients with these types of wounds.
  • Apply hydrocortisone cream 2 to 3 times daily as needed for itching. Discontinue immediately if any signs of infection appear.
  • Oral antibiotics are usually recommended to treat an infection.

When to Seek Medical Care for a Starfish Puncture Wound

  • Seek medical treatment as soon as possible.
  • Consult a doctor about treatment with available medications.

Starfish and Crown of Thorns Pictures

Unlike most starfish that are typically pentamerous, the crown of thorns starfish may have as many as 23 arms and a body disk of up to 60 cm in diameter. Photo courtesy of Dee Scarr.
Unlike most starfish that are typically pentamerous, the crown of thorns starfish may have as many as 23 arms and a body disk of up to 60 cm in diameter. Photo courtesy of Dee Scarr. Click to view larger image.

Detail of the crown of thorns starfish spines, which may grow to 6 cm in length. Photo courtesy of Dee Scarr.
Detail of the crown of thorns starfish spines, which may grow to 6 cm in length. Photo courtesy of Dee Scarr. Click to view larger image.

Scuba Health: Cuts, Scrapes, and Other Diving Injuries

Scuba health: Common medical problems in scuba diving include cuts, scrapes and other injuries to the arms and legs and pain in the ear (the "squeezes") due to the difference in pressure between the middle ear and mask during the descent into the water. Less common but more dangerous health hazards of scuba diving include inner ear barotrauma, pulmonary barotrauma, arterial gas embolism (AGE), and decompression sickness ("the bends").

Inner ear barotrauma occurs when the diver has trouble clearing during a dive and is characterized by severe dizziness and hearing loss. Pulmonary barotrauma results from improper breathing during the ascent or diving with a respiratory tract infection and is characterized by hoarseness, shortness of breath and chest pain. Arterial gas embolism (AGE) is a very serious form of pulmonary barotrauma in which bubbles enter the circulation and travel to the brain causing numbness or tingling of the skin, weakness, paralysis and sometimes loss of consciousness.

Decompression sickness ("the bends") occurs during ascent and on the surface of the water when inert nitrogen gas dissolved in body tissues and blood comes out of solution and forms bubbles in the blood. The bubbles can block blood vessels and injure organs, particularly the spinal cord, brain and lungs.

SOURCE:
MedTerms.com. Scuba health.

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Reviewed on 11/20/2017
Sources: References

Patient Comments & Reviews

  • Starfish (Sea Star), Crown of Thorns, Puncture Wounds - Treatment

    How did you treat your puncture wound?

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