Marine trauma, envenomations, and intoxications.

When humans encounter marine creatures a variety of maladies may occur, ranging from dermatitis to life-threatening trauma, allergy, envenomations, or intoxications. The emergency physician should be prepared to recognize quickly and address appropriately the potential life threats, which are primarily neurologic, respiratory, and cardiovascular. A high degree of suspicion for these illnesses is needed. Intoxications may be especially confusing. Although most of the syndromes are self-limited and treatment supportive, time is of the essence if neuromuscular paralysis, hypotension, or respiratory compromise is present. Much folklore exists regarding detection and prevention of these entities and should be regarded as such. The last several decades have seen a marked increase in our knowledge base regarding these fascinating envenomations and intoxications. Research in the next several decades probably will produce a variety of diagnostic and therapeutic tools, which will further our understanding of, and ability to specifically manage, these syndromes.