Regarding most marine envenomations, empiric attempts to denature the toxin are generally recommended (Lionfish, stingrays, echinoderms, etc) by placing the affected limb into water at 114F.
A review of echinoderm envenomations:
http://www.emedicine.com/emerg/topic158.htm
A review of general marine dangers:
http://www.medscape.com/viewarticle/512590_2
In a true emergency, it doesn't matter what you've been zapped with. If facing airway issues or circulatory collapse, management is my problem, not yours. Call 911 and we will look up whatever we need to. I have an endless supply of references, including subscription services and even an online network of physicians should you come up with something to stump me.
Where it would be helpful:
a) You have this strange bump on your finger that's been there for a long time, and you noticed after messing around in your tank. Same goes for weird rashes. These aren't emergencies, but there are certain bacteria in saltwater that we think about if we know you're a fisherman...
b) You keep some sort of exotic critter that could kill you. (Blue-ringed octopus, Box jellyfish, etc) - Put a card in your wallet or signs on your walls that the paramedics wouldn't miss. It may not matter anyway, as I'm not going to pause from my full court press to save you to look up some esoteric toxin. I'll empty my code cart first.
c) If you ever have any signs of serious allergic (re: anaphylactic) reaction to anything in your tank, you need to have an epi-pen available. Just in case. I mean, I break out in hives if I brush against hydroids. I avoid them. But I'm aware of it. It's like a bee sting allergy... but then again, it's like a bee sting allergy. If you show up at my door, we follow a common pathway to try to save your life.
Oh, and if you do get exposed to this mythical palytoxin that does not appear in the medical literature (I looked, and if anyone can find a reference to any case report of dermal or transdermal intoxication, I'd appreciate it), you are going to get the same treatment anyone else presenting with cardiovascular collapse gets. Oh, and if you do, and happen to survive, I want to hear about it.
The initial citation:
Moore, Richard, and Scheuer, Paul.
Palytoxin: A New Marine Toxin from a Coelenterate. Science 30 April 1971: Vol. 172. no. 3982, pp. 495 - 498.
There are plenty of reports of people dying from palytoxin, however they are all secondary to ingesting fish that have ingested dinoflagellates that have ingested... and so on. None in the US that I could find. Interestingly, palytoxin is now being blamed for deaths previously declared related to ciguatura poisoning. In any case, I cannot find any that have anything to do with handling the originating species, which, according to Hawaiian legend, is found in only one tidepool. (Is it really? Who knows.) Moral of the story? You could still get hit by a bus and are more likely to die in a car crash anyway.
Gosh, I didn't mean for that to come off like a rant. I guess my bottom line is just to be smart and know what you're dealing with. Which is why a reef MSDS is a great idea!
Danielle
