If a significant envenomation has occurred, the individual will rapidly progress from perioral and peripheral paresthesias through the following signs and symptoms. Ataxia Muscle paralysis Respiratory failure, which may lead to cardiac arrest and death Anaphylactoid or anaphylactic reactions have rarely been reported. Local reaction may be minimal, but it can progress to include pain, edema, and erythema of the entire extremity. The patient becomes flaccid once paralyzed. Envenomations usually occur when an individual picks up a blue-ringed octopus or accidentally steps on one.
Laboratory studies are non-contributory.
A general workup for a critically ill patient is recommended to rule out other etiologies for acute paralysis and respiratory failure. Imaging studies are generally not helpful. A plain film of the puncture site may be indicated to rule out a foreign body. What constitutes proper wound care is controversial. Perform local suction without incision or local sequestration of the venom by applying a constricting band proximal to the injury.