Cone snails

Pressure immobilisation first aid should be applied and left in place until resuscitation facilities are available. Assisted ventilation may be required. There is at present no antivenom for cone shell stings. The wound should be regarded as potentially contaminated, and tetanus prophylaxis should be updated if required.

Cone snail venom consists of numerous neurotoxic peptides that act pre- and post-synaptically to give rise to neurological symptoms of weakness, lack of co-ordination and disturbance of vision, speech and hearing. Less common systemic symptoms include nausea and generalized pruritis. Local symptoms of pain, swelling and numbness are common. Severe envenomation may result in death secondary to respiratory muscle paralysis.