海水生物螫傷可以泡 40-45 度c熱水.
使用預防性抗生素. 要預防 Vibrio
Pain control — We suggest that patients with pain following marine envenomations undergo hot water immersion of the involved area (water temperature 40° to 45°C) for up to 90 minutes. If a thermometer is not available, the clinician can use the hottest water temperature that is tolerated by the patient on an unaffected limb; adults should test the water temperature for young children. Hot water immersion should not be used for longer than 90 minutes and is contraindicated in patients who have had local or regional anesthesia for pain control. There is considerable risk of burns in patients with exposure for longer than 90 minutes and the risk increases with water temperature and duration of exposure.
67% 病患在泡熱水之後疼痛會減緩.
Unlike jellyfish stings where there is good evidence for the effectiveness of hot water immersion, the evidence to support this therapy for penetrating marine injuries is primarily derived from case reports, small case series, and anecdotal experience. Universal pain relief is not necessarily achieved [6,8,11,12,26,27]. As an example, in a retrospective series of 97 patients with stingray envenomation, 67 percent had complete analgesia with hot water immersion alone [14].
不可以打完局部麻醉之後再泡熱水.
Patients may also receive opioids (eg, intravenous morphine) for moderate to severe pain and nonsteroidal antiinflammatory drugs (eg, ibuprofen) or acetaminophen for mild pain [26]. If pain persists, local or regional anaesthesia may also be required but should never be combined with hot water immersion. (See "Overview of peripheral nerve blocks".)
Patients with severe pain that is unresponsive to hot water immersion and pain medications after stonefish envenomation may be candidates for stonefish antivenom. However, efficacy is uncertain. (See 'Stonefish antivenom' below.)
Use of hot water immersion for jellyfish stings is discussed in detail separately. (See "Jellyfish stings", section on 'Hot water immersion'.)
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