Note: If anaphylaxis is evident, the causative agent is of secondary concern, and the patient should be treated for anaphylaxis without waiting to determine the cause.
The following key is intended only as a guide to aid in the identification of the agent of envenomation where venom intoxication has already been diagnosed. It should be remembered that the suggestion arrived at by using this key should remain consistent with the patient’s history and the clinician’s own opinion.
| 1. |
| a. | Sting site characterised by erythematous lines, often numerous; evidence of contact with tentacles: jellyfish. |
| b. | Small puncture mark, or marks absent initially: blue-ringed octopus, cone snail, irukandji. Go to 2. |
| c. | Scratches or uneven puncture marks, sometimes paired: sea snake. |
| d. | Large, obvious puncture mark, sometimes several in line. Often foreign material in wound: stinging fish. |
| 2. |
| a. | Immediate pain moderate to severe: cone snail. |
| b. | Pain initially mild or absent: blue-ringed octopus, irukandji, sponge. Go to 3. |
| 3. |
| a. | Back or abdomen pain, pain in limbs or joints, some time (perhaps around 30 minutes) after the envenomation: irukandji. |
| b. | Numbness or weakness around the face, with or without nausea and vomiting: blue-ringed octopus. |
| c. | Pain onset ten or more minutes after the envenomation. Erythematous areas, rash-like appearance: sponges. |
