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Stingray

A stingray is a sea animal with a whip-like tail. The tail has sharp spines that contain venom. This article describes the effects of a stingray sting. Stingrays are the most common group of fish that sting humans. Twenty-two species of stingrays are found in US coastal waters, 14 in the Atlantic and 8 in the Pacific.

This article is for information only. DO NOT use it to treat or manage an actual stingray sting. If you or someone you are with is stung, call your local emergency number (such as 911), or your local poison control center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States.

Poisonous Ingredient

Stingray venom contains many toxic chemicals.

Where Found

Stingrays and related species that carry toxic venom live in oceans all over the world.

Symptoms

Below are symptoms of a stingray sting in different parts of the body.

AIRWAYS AND LUNGS

  • Breathing difficulty

EARS, NOSE AND THROAT

  • Salivating and drooling

HEART AND BLOOD

  • No heartbeat
  • Irregular heartbeat
  • Low blood pressure
  • Collapse (shock)

NERVOUS SYSTEM

  • Fainting
  • Body cramps and muscle twitching
  • Headache
  • Numbness and tingling
  • Paralysis
  • Weakness

SKIN

  • Bleeding
  • Discoloration and blistering, sometimes containing blood
  • Pain and swelling of lymph nodes near the area of the sting
  • Severe pain at site of sting
  • Sweating
  • Swelling, both at the sting site and throughout the body, especially if the sting is on the skin of the trunk

STOMACH AND INTESTINES

  • Diarrhea
  • Nausea and vomiting

Home Care

Seek medical help right away. Some stingray stings can be serious and require professional care.

For superficial stings to an arm or leg, while waiting for medical help, you can provide initial treatment to help alleviate pain and prevent infection:

  • Immediately get out of the water and into a safe environment.
  • Control bleeding (if any) by applying direct pressure to the wound with a clean cloth or bandage.
  • Next soak the wound with hot water. Immerse the affected area in water at 40 to 45 degrees Celsius, or if no thermometer is onsite, then as hot as can be comfortably tolerated on an unaffected limb. Soak the wound for 30 to not longer than 90 minutes, periodically checking the water temperature to maintain its warmth.
  • After soaking, gently wash the wound with mild soap and clean water to remove any dirt, debris, or venom that may be present.
  • If not allergic, apply an over-the-counter antibiotic ointment.
  • Cover the wound using a sterile bandage or a sterile non-stick dressing with tape.

Before Calling Emergency

Have this information ready:

  • Person's age, weight, and condition
  • Type of sea animal
  • Time of the sting
  • Location of the sting

Poison Control

Your local poison control center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. They will give you further instructions.

They will tell you if you should take the person to the hospital. They will also tell you how to do any first aid that can be given before you get to the hospital.

This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.

What to Expect at the Emergency Room

The health care provider will measure and monitor the person's vital signs, including temperature, pulse, breathing rate, and blood pressure. The wound will be soaked in a cleaning solution and any remaining debris will be removed. Symptoms will be treated. Some or all of these procedures may be performed:

  • Blood and urine tests
  • Breathing support, including oxygen, tube through the mouth into the throat, and breathing machine (ventilator)
  • ECG (electrocardiogram, or heart tracing)
  • Intravenous fluids (IV, through a vein)
  • Medicine called an antiserum to reverse the effect of the venom
  • Medicine to treat symptoms
  • X-rays

Outlook (Prognosis)

The outcome often depends on how much venom entered the body, the location of the sting, and how soon the person receives treatment. Numbness or tingling may last for several weeks after the sting. Deep stinger penetration may require surgery for removal. Skin breakdown from the venom is sometimes severe enough to require surgery.

A puncture in the person's chest or abdomen may lead to death.

References

Auerbach PS, DiTullio AE. Envenomation by aquatic vertebrates. In: Auerbach PS, Cushing TA, Harris NS, eds. Auerbach's Wilderness Medicine. 7th ed. Philadelphia, PA: Elsevier; 2017:chap 75.

Curtis AM, Erickson TB. Venomous animal injuries. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 53.

Liao L, Norris RL, Nelson EE, Stewart RM. Bites and stings. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed. St Louis, MO: Elsevier; 2022:chap 21.

Stone DB, Scordino DJ. Foreign body removal. In: Roberts JR, Custalow CB, Thomsen TW, eds. Roberts and Hedges' Clinical Procedures in Emergency Medicine and Acute Care. 7th ed. Philadelphia, PA: Elsevier; 2019:chap 36.


         

        Review Date: 7/1/2023

        Reviewed By: Jesse Borke, MD, CPE, FAAEM, FACEP, Attending Physician at Kaiser Permanente, Orange County, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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