Doctor's Notes on Stingray Injury
Stingrays are aquatic members (mainly salt water) flat body with wing-like fins, with a long tail containing a barbed structure at its tip called a spine or stinger containing venom, used for defense (are not aggressive unless threatened). Some rays (manta rays) do not have a stinger and are harmless. Injuries are caused by the whip-like action of the tail and the venoms or toxins contained in a sheath covering the stinger. Signs and symptoms may include a cut or laceration where the sheathed stinger hits the skin (parts of the sheath and stinger may be left in the wound). The released toxins can cause immediate and severe pain that may radiate up a limb, cause swelling, bleeding, and wound color changes (bluish to red) and systemic symptoms like sweating, saliva production, nausea, vomiting, diarrhea, headache and weakness. In some people, more severe symptoms like low blood pressure, muscle cramps and/or paralysis, short of breath, heart arrhythmias and seizures may occur. Rarely, death from blood loss from puncture wounds to the heart or abdomen have happened.
The causes of stingray injuries are due to cuts or lacerations by the whip-like action of the tail that puts the barbed stinger and the toxins located in the stinger's sheath into the skin (sometimes so deep it may lacerate an organ). Usually, the bigger the stingray, the more severe the signs and symptoms. However, most stingray injuries should be evaluated in an emergency department.
Stingray Injury Symptoms
The stinger, or spine near the base of the tail, is hard and sharp with backward pointing barbs (retroserrations) that can cause a jagged cut. It can be difficult to remove from a wound because of the back-facing barbs. There can be 1-4 spines at the base of the ray’s tail depending on the species.
A skinlike covering, the sheath, over the stinger encloses the venom glands. The spine lies in a groove along the tail. Injury from a stingray can damage a person's muscles or tendons in addition to the cut or puncture wound. Part of the sheath and spine can be left in the wound. The venom is composed of many different substances that cause tissue to break down and die as well as cause severe pain.
The toxins contained in the sheath can cause the following symptoms:
- Immediate and severe pain radiating up the limb and lasting up to 48 hours
- Swelling in the wounded area
- Bleeding from the wound
- Color change in the area of injury—first dusky blue, then red
- Low blood pressure
- Faintness, weakness, dizziness
- Salivation, nausea, vomiting, diarrhea
- Shortness of breath
- Muscle cramps and pain, paralysis
- Heart rhythm irregularities
- Death, though rare, has been reported from a puncture of the heart or abdomen and from loss of blood.
Stingray Injury Causes
Most stingray injuries typically occur when a person accidentally steps on a ray as it lies on the shallow, sandy bottom of a beach area. Rays often cover themselves with sand for camouflage while resting or hiding from predators, so they can be hard to see. When stepped upon or harassed, they swing or arch their tail in the direction of the intruder as a defensive maneuver to protect themselves. This drives their spine into the unwanted intruder. The ray’s tail can reach all the way to the front of its head for protection.
People who step on a stingray most frequently are injured on their feet and lower legs. Hands and arms can be injured if a person tries to touch or catch one.
- A fisherman, for example, can be injured removing a stingray from a net or fishing line.
- In rare cases, the stingray's powerful spine has penetrated a person's abdomen or chest causing severe injury.
- Rays found in home aquariums can cause injuries.
- You can prevent injury by shuffling your feet while walking or wading through water to startle and shoo them away. Wearing footwear such as sneakers or dive booties may not help because the spine can penetrate them.
- Don't try to chase or ride a stingray.
- If you have hooked one, cut the line and release it. A seemingly dead ray can whip its tail in defense and cause an injury.
- Certain rays, such as skates and manta rays, do not have a stinger at the base of their tails and are harmless.
- Some rays in marine parks are friendly because they have become used to humans, and you can touch them. These rays are more likely to give you a hickey from the suction action created by their mouths when trying to feed on your hands. Venom is only located in the tail spine.
Their tentacles contain venom, so getting stung can be painful or sometimes life-threatening. Stings usually happen by accident when you carelessly handle a jellyfish, or swim or wade among them.
Trauma and First Aid : Training and Supplies QuizQuestion
Emotional trauma is best described as a psychological response to a deeply distressing or life-threatening experience.See Answer
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.