Jellyfish Sting: Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps:

  • General physical examination – including blood pressure, pulse, body weight, height; further:
    • Inspection (viewing).
      • Skin [swelling of skin due to hives?, blistering if any?, necrosis if any (death of cells/cell death)]Note: The length of the welts on the skin caused by the tentacles provides information about the degree of poisoning.
      • Neck veins
      • Angioedema due toanaphylactic shock (bulging elastic swellings (eg, in the facial area: lip, cheeks, forehead) that appear suddenly and disfigure the appearance)]
    • Auscultation (listening) of the heart.
    • Auscultation of the lungs [bronchospasm/cramping of the muscles surrounding the airways].

Square brackets [ ] indicate possible pathological (pathological) physical findings.

Glasgow Coma Scale (GCS) – scale for the estimation of a disorder of consciousness.

Criterion Score
Eye opening spontaneous 4
on request 3
on pain stimulus 2
no reaction 1
Verbal communication conversational, oriented 5
conversational, disoriented (confused) 4
incoherent words 3
unintelligible sounds 2
no verbal reaction 1
Motor response Follows prompts 6
Targeted pain defense 5
untargeted pain defense 4
on pain stimulus flexion synergisms 3
on pain stimulus stretching synergisms 2
No response to pain stimulus 1

Assessment

  • Points are awarded for each category separately and then added together. The maximum score is 15, the minimum 3 points.
  • If the score is 8 or less, a very severe brain dysfunction is assumed and the there is a risk of life-threatening respiratory disorders.
  • With a GCS ≤ 8, securing the airway by endotracheal intubation (insertion of a tube (hollow probe) through the mouth or nose between the vocal folds of the larynx into the trachea) must be considered.