Stonefish envenomation

A. Systemic intoxication associated with stonefish envenomation can include the rapid onset of hypotension, tachycardia, cardiac arrhythmias, myocardial ischemia, syncope, diaphoresis, nausea, vomiting, abdominal cramping, dyspnea, pulmonary edema, cyanosis, headache, muscular weakness, and spasticity. 

B. Specific drugs and antidotes. Immediately immerse the extremity in hot water (45°C or 113°F) for 30-60 minutes. This should result in prompt relief of pain within several minutes. For stonefish envenomations, a specific an-tivenin can be located by a regional poison control center (in the United States, [800] 222-1222), but most of these cases can be successfully managed witti hot water immersion and supportive symptomatic care. 

A. Synanceja (Australian stonefish) have short, strong spines with the venom gland located near the tip therefore, large doses of venom are delivered and severe envenomation results. 

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