8
18 31
E V M
asystole NSS adrenaline 4 ampules
2 2 1
1 40 50
2549 1
11 33
60 70
Third degree burn 3
48 2 35 3 3
31 8 4 4
5
15, 17
2550 2 4
6
11, 17
2 6
1 1 Andrew Jones
13 35
1 2 1 2
3 5
60
Irukandji Irukandji like syndrome 6, 15, 17
4
2 7
11, 17
2 7
5
2 8
antihistamine
Chironex
11, 17
2 8
1 1
6
11, 15, 17
2 8
7
29 Irukandji
8
25 13 00 15 00
33
15
30 2 9
74
150 120 20 37
2 9 15, 18, 19
2 9
9 6
4
60 41 162
50 38
30 crepitation
anaphylactic shock 5
15
10
9 2 7
16
5 6 25
1 11 12
2 3
1 6 1
1 20 30
17, 20
2 10
11
23 16 30
21 175
1 2 5 2
125 10
17 55
113 150 75
2 11 5
2 11
5
12
2
fluctuance Multiple maculopapular rash
35
25 Radial pulse Fasciotomy
Compartment syndrome Severe subcutaneous edema fascia Subcutaneous fluid acute inflammatory cells skeletal muscle fibers
myofiber necrosis Wound exploration Fasciotomy Compartment
syndrome 10 17 split
thickness skin graft Multiple blisters 2 12 Full
thickness like patch of skin necrosis
28 35 split thickness skin
graft 21
2 2 digital gangrene YW
Hung
2557 13
17 13 55
45 4
2 2
153 93 morphine codeine
2 13 15
2 13
27 17 40 39
8 1 5 2 0 20 30
03 41
190 100 68
15
18 14 30 32
10 2
147 100
76 20
2 14 25
2 14
16
00
morphine
25
17
6
diclofenac diclofenac
6
2 16
2 17 7
20 30
E4V5M6 first degree burn
contact box jellyfish to be ruled out
ibuprofen paracetamol siver cream
E4V5M6 wheezing tramadol 1 ampule IV, tramadol CPM
19
15 11
12 00 30
CPM 1
10 CPM
1
anaphylaxis CPM, Hyoscine Butylbromide
omeprazole, CPM, Hyoscine Butylbromide CPM
14 41 2 2 5
138 81 80 20 Abdominal pain
25 2 18
3 5 3 4 1
2 3 6
3 Irukandji like Syndrome
buscopan 1
2 18
3
12 18 15 18 20 31
0 5 5 18 30
E1V1M5 86 63 156
32
9
10 15
9 00 13
1 2 31
15
2 19
21
24
23
20 46 157 29
122 22
2 20
Pethidine parecoxib 40 2
4 24 00
20
26 2 21
2 21
2
24 11
2 22
2 22
23
22 17
2 23
24
21 10 22
42 2
1
15 10 52
141 69 80 22
2 24
2 24
2 25
20
118 154 76 22
pethidine 30
2 25 Morbakkaspp
26
17 2
20 37 5 88 60
160 20 cyanosis
6 Morphine sulphate Magnesium sulphate
2 26
27
2 27
2 28 Morbakkaspp
28
13 17 00
2
17 0 19 30
20 00
155 80 96
22 36 5
97
1
30 CPM 1
ampule, Dexamethasone 1 ampule, Dynastat 1 ampule, 0 9 NaCl 80
oxygen cannula 3
10
9
22 12 00
48 2 29
12 39 140 99
80 Tramadol, Morphine
sulfate, Diazepam Silver
sulfadiazine cream 1 Dicloxacillin Tramadol HCl 4
2 29
2 2
2 29
5 40
30
12 00
14 10
1 5
1
2 13 30
150 90 130 30
70 20
2 30
30
31
19 10
100 30
ventolin NSS Oxygen mask with bag
8 08 20
0
12 80 108 30
E4V5M6 4
40 CPM, Dexa, Adrenaline, Ranitidine, Beradual
E V M
Congestive Heart Failure Furosemide
O cannular
5
30 2 31
11 2
99 0 9 NSS
1 6
1 2
1
99 EKG 12 lead sinus tachycardia without ST change
2 31
33
1
152 72
114 22 36 8
E4V5M5
on oxygen mask
36 5
E4V5M6 113 76 22 EKG prolong
QT CBC
neutrophil 94 6 lymphocyte 1 8 electrolyte 30
2 32 2 32
Chironexspp 22, 23
2 32
34
147 94
94 24
2 33 2 33
CPM 1 ampule IM, Pethidine 50 mg IM, Ibuprofen 400 mg 1
3 Hot pack
128 78
70 22
5 7 2 33
15
6
5 7
35
6 18 15 18 20
18 44 159 110
84 20 36 8
hot immerging 45 45
36
37 131
20 WBC 11,200
compartment syndrome
20
Chlorpheniramine milligram ampule, Alcohol mg Triamcinolone cream
Chlorpheniramine mg
3 BURN DEGREE AT ARM
2 34
37
24 52
62
137 77 20 2 35
15 40
48 125 65
18 Oxygen sat 100 roomair DTX 109 mg
5 10 0 9 NSS 1000 ml IV
80 ml hr Morphine 5
2 152 81 115 62
68 58 22 20
Pain score 1 2
Chironexspp 2 35
2 35
2 2
1 2556 2 35
13
Physalia utriculus 28
13 5 1 47
2 26
2 36 70
24
24
Physaliaspp 2 36 23
2 36 Physalia utriculusi
2 2
2 37
NSS Fentanyl mg paracetamal EKG
leads Hematology x cell Hct
x ul Neutrophil Lymphocytes Jellyfish T
Toxic effect of contact with venomous animals
anaphylaxis paracetamol CPM
2 37 Physalia utriculus
CBC EKG Jellyfish irritant Fentanyl, CPM syrub paracetamol syrub
x cell
Hct x ul, Neutrophill , Lymphocytes
paracetamol CPM
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The epidemiologist life blog 2556 2 60 http oknation nationtv tv blog peeguay 2013 09 30 entry 1
14 The epidemiologist life blog
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http www oknation net blog peeguay 2014 01 02 entry 1
15 Thaikruea L, Siriariyaporn P The magnitude of severe box jellyfish cases on Koh Samui and Koh Pha ngan in the Gulf of Thailand BMC Research Notes 2016;9 1 108
16 Suntrarachun S, Roselieb M, Wilde H, Sitprija V A fatal jellyfish encounter in the Gulf of Siam J Travel Med 2001;8 3 150 1
17 Thaikruea L, Siriarayaporn P Situation of injurries and deaths in Thailand In Thaikruea L, editor Injuries and Deaths Caused by Box Jellyfish and Portuguese man of war Treatment and Prevention Chiang Mai Faculty of Medicine of Chiang Mai University Publishing; 2014 p 23 42
18 Thaikruea L, Siriarayaporn P Jellyfish In Thaikruea L, editor Injuries and Deaths Caused by Box Jellyfish and Portuguese man of war Treatment and Prevention Thaikruea L, editor Chiang Mai Faculty of Medicine of Chiang Mai University Publishing; 2014 p 1 22
19 Thaikruea L, Siriariyaporn P Severe Dermatonecrotic Toxin and Wound Complications Associated With Box Jellyfish Stings 2008 2013 J Wound Ostomy Continence Nurs 2015;42 6 599 604
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The epidemiologist life blog 2556 2 60 http www oknation net blog peeguay 2013 02 14 entry 1
21 Lam L, Chan W, Kwok T, Chiu H Digital ischaemia a rare but severe complication of jellyfish sting Hong Kong Med J 2014;20 3 S20 3
22 Thaikruea L, Leelarasamee A Which First Aid Treatment Is Appropriate for a Bizarre Skin Lesion and Cardiovascular Collapse after Swimming in the Sea? J Med Assoc Thai 2018;101 8 1143 4
23 Thaikruea L, Santidherakul S The public health impact of a new simple practical technique for collection and transfer of toxic jellyfish specimens and for nematocyst identification Journal of Public Health Policy 2018;39 2 143 55
24 The epidemiologist
life blog 2561 5 2 61
http oknation nationtv tv blog peeguay 2018 02 25 entry 1
Andrew Jones Dr Ken Winkel Australian Venom Research Unit, University of Melbourne Dr Lisa_Ann Gershwin Australian String Advisory Services Mr John Lipaman Diving Alert Network ASIA PACIFIC