There are multiple risks associated with contact with the various marine animals that can be found during diving. The objective of this course is not to comprehensively address all possible lesions and their treatments, but to give basic and general lines of action.

POISONOUS FISH

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It is not always easy, after an accident, to make the identification of the fish (or other marine being) responsible for the injury, but this does not matter much, since the effects that the poisons cause and the attitude to be taken is practically the same.

Poisonous fish are rarely aggressive. Contact is most often purely accidental, due to distraction from the diver, or due to the undue handling of the fish. It must not be forgotten that even after the fish is dead, the thorns remain poisonous .

In most cases, the poison is very sensitive to heat, degrading if it is subjected to a high temperature. The application of hot water (or any other heat source) is a practical way to reduce its effect.

STONEFISH, SCORPIONFISH AND LIONFISH

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Synanceia verrucosa (stonefish), Scorpaenopsis diabolus (scorpionfish) and Pterois sp. (lionfish) are highly toxic tropical water fish. The toxins of these fish produce effects very similar to those of other poisonous fish, but often associated with more severe symptomatology , such as respiratory arrest, shock, cardiovascular collapse and even death.

In addition to the usual first aid procedures in these types of accidents, there are in hospitals antitoxins specific to these special cases. For this treatment to be applied it is necessary to inform the hospital that the injury was caused by one of these fish.

Although in our waters are not frequented by these fish, the Scorpaena porcus (rascasso-de-pintas) is quite common on our coast. This fish, very common in the rocky bottoms, is usually camouflaged among the algae and has a very powerful poison.

RAYS

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In most cases of accidents with rays, what happens is the diver stepping or disturbing the streak and this has a defensive movement with the tail when trying to escape, resulting in extremely painful wounds.

HYDROZOANS

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In most cases the result of contact with these beings is only a local irritation of the skin, but that can be very painful, as with the small Pelagia noctiluca (jellyfish), very common in the Azores.

The most careful cases are Sea wasp and Physalia physalis (Portuguese caravel).

CORAL

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Due to its sometimes cutting or abraziva structure, contact with coral can result in important wounds that sometimes take a long time to heal, often arising secondary infections. In addition, some corals have hive cells, which can cause severe burns, as with Millepora platyphylla (coral-fire).

Wounds resulting from contact with coral should be disinfected, kept clean and guarded. In some cases, observation and treatment by health professionals may even be justified, especially when coral is urticante.

Prevention, once again, is done by avoiding contact. As a precaution, the diver should always wear protective clothing, even in warm waters.

THE GREAT PREDATORS

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In our waters there are no reports of shark attacks. The species here are pelagic and are far from the coastal areas frequented by divers. Even where these animals abound, attacks on divers are rare (statistics in Australia show that diving accidents are much more numerous than shark attacks).

The reasons for a shark’s attack are almost always unknown, although many theories are advanced, and attacks are often unpredictable.

On the other hand, the shark’s behavior before starting an attack is predictable. The animal swims in increasingly tight circles around the prey, with wide movements and with pectoral fins directed down (the normal is to be directed to the sides), and the attack may be preceded by a sudden acceleration or other behavioral change.

The injuries can be caused not only by biting but also by contact, since the shark’s skin is very rough, because it is covered with very sharp small spicules. Thus, contact with the shark can result in significant abrasions and significant bleeding.

There are a number of rules to abide by to prevent the attacks of these animals, of which the most obvious is to avoid diving in the places where they find. Don’t forget that a shark swims ever faster than any swimmer or diver.

The result of a shark attack is usually very serious, requiring urgent hospital treatment.

FIRST AID AND TREATMENT

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POISONOUS FISH

• Remove the injured person from the water, pour it on a flat surface, reassure and watch, pay particular attention to the signs of shock.
• Wash the wound (serum). Wound suction to remove poison is not effective.
• Place the affected area in hot water (maximum temperature tolerated up to 50ºC) for 30 to 90 minutes. If there is intolerance to prolonged contact with hot water, make short and repeated immersions. In wounds on the face, use compresses or hot cloths.
• Transporting the injured to the hospital, tourniquets and bandages are not advised.

HYDROZOANS

• Remove any tentacle without rubbing or scrubbing, preferably with a towel or piece of clothing.
• Wash the wound with acetic acid (3 to 10%), to prevent the release of more toxins.

CORALS

• Controlling bleeding
• Clean and disinfect the wound
• Make a dressing
• Administer the tetanyca vaccine
• Administer topical or systemic antibiotics if justified