[abstract] JELLYFISH VENOMS AND THE DIVER - LESSONS FOR DIVING MEDICINE.

Abstract

BACKGROUND: Epidemiological, toxinological, immunological and clinical research (Hydrobiologia 216/217;629,1991) is revealing jellyfish envenomation patterns and risk situations relevant to diving safety and medicine. Medical calls concerning envenomated divers are increasing. SPECIFIC ENVENOMATION PROBLEMS: "Irukandji" Syndrome (Med J Aust 153;164, 1990) may produce prostrating muscular pains and symptoms of massive sympathetic discharge, 1/2 h following envenomation. Uncommonly, serious cardiac decompensation may follow later. This envenomation in divers can be mistaken for decompression illness. Recompression is valueless. Management is in-hospital intravenous (IV) narcotic infusions, and IV phentolamine for serious hypertension. SeriousAtlantic Physalia physalisenvenomations in SCUBA divers: One fatal (Toxicon 27;823, 1989) and two serious stingings are documented. Blind ascent into the animal occurred. Rapid, painful leg and chest muscle spasms with dyspnoea unrelieved by oxygen, follow stinging. Acute hypoxia and/or anaphylaxis (J Allergy Clin Immunol 75;672, 1985) may require resuscitation. Full wet suit, correct ascent technique ("look up, reach up, come up") reduces diver risks. CONCLUSION: Know jellyfish species' distributions; seek history of jellyfish sighting or sting, of adherent tentacles or marks (minimal with Irukandji); note "all over" muscle pains, unrelieved by 100% oxygen.