Symptoms and Signs of Stingray Sting

Doctor's Notes on Stingray Sting

Stingrays are aquatic animals (mainly saltwater) related to sharks that have a flat body with wing-like fins and a long tail containing a barbed structure at its tip (called a spine or stinger containing venom) that they use 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 and signs like

• sweating,
• saliva production,
• nausea,
• vomiting,
• diarrhea,
• headache, and
• weakness.

In some people, more severe symptoms and signs may occur and include

• low blood pressure,
• muscle cramps and/or paralysis,
• shortness of breath,
• heart arrhythmias, and
• seizures.

Rarely, death from blood loss from puncture wounds to the heart or abdomen have happened.

Usually, the bigger the stingray, the more severe the signs and symptoms. However, most stingray injuries should be evaluated in an emergency department.

What Are the Treatments for Stingray Stings?

Stingray sting treatment is as follows:

• Flush wound with fresh water.
• Immerse the sting area in water as hot as the person can stand it for about 30-90 minutes; repeat as necessary for pain control.
• Remove all stingers or barbs from the wound with tweezers if the wound is not too deep; deep wounds may require pressure to staunch bleeding.
• Scrub the wound with soap and water, and then rinse with a lot of water.
• Leave the wound open.
• Take over-the-counter pain medicine.
• Look for signs of infection such as redness, heat, and exudate (rarely infected). You may need a tetanus shot.
• Apply topical ointment and/or antibiotics if the wound becomes infected.
• Note that a very large stingray can whip the stinger deep into the abdomen and heart. Call 911 and do not attempt to remove the stinger.
• For severe allergic reactions and deep organ penetration, the patient may need cardiopulmonary resuscitation.