The integumentary sheath surrounding the spine ruptures, and the venom escapes into the victim's tissues, causing immediate severe pain. Lymphangitis, vomiting, diarrhea, sweating, generalized cramps, inguinal or axillary pain, and respiratory distress have been reported. The wound is usually jagged, bleeds freely, and is often contaminated with parts of the integumentary sheath. The edges of the wound are often discolored, and some localized tissue destruction may occur. Generally, some swelling and edema are present.
Open wounds are subject to infection.
Injuries to an extremity should be irrigated with the salt water at hand. An attempt should be made to remove the integumentary sheath if it can be seen. The extremity should then be submerged for 30 to 90 min in water as hot as the patient can tolerate without injury. The wound should be reexamined for remnants of the sheath and debrided. An appropriate antitetanus drug should be given, and the injured extremity elevated for several days.