Emergency Flowchart

Signs and symptoms¹	Emergency medical treatment	Possible culprit²	Antivenom


Strong pain, superficial or deep puncture wounds Injury to major vessels, nerves; penetration to internal organs with or without additional effects of the venom	Superficial puncture wounds: Infiltration of a local anaesthetic without the addition of a vasoconstrictor (lignocaine 1%); Nerve block anaesthesia (lignocaine, bupivacaine); Major vessel damage and pentrating wounds: Surgical treatment	Stingrays (Catfishes)

Strong pain, puncture wound(s) primary cardiac and neurological, including autonomous effects	Puncture wounds: See above Cardiac/neurological effects: supportive treatment	Stonefishes	Stonefish antivenom

		Other venomous fish probable

Strong pain, puncture wound	Puncture wounds: See above	Catfishes Weeverfishes


(Strong) pain, puncture wound	Puncture wounds: See above	All other stinging fish

1	See also the Clinical flowchart as a guide to the dynamics of envenoming.
2	Taxonomic name without parentheses/(in parentheses)/((in double parentheses)): these signs and symptoms are regularly/(rarely)/((questionably)) observed following bites by these species.