Most fish poisonings occur from eating fish thatnormally are considered to be safe to eat. However,fish can become poisonous at different times of theyear because of their consumption of poisonous algaeand plankton (red tide) that occur in certain locations.The signs and symptoms of red tide paralytic shellfishpoisoning are tingling and numbness of the face andmouth, muscular weakness, nausea and vomiting,increased salivation, difficulty in swallowing, andrespiratory failure. Primary treatment is directed atevacuating the stomach contents as soon as possible. Ifthe patient has not vomited, select the appropriatemethod to remove the stomach contents by either syrupof Ipecac or gastric lavage. If respiratory failuredevelops, support ventilation and other life-sustainingsystems as needed.Examples of fish that are known to be poisonousAT ALL TIMES are shown in figure 5-1.The symptoms of shellfish and fish poisoning aretingling and numbness of the face and mouth, muscularweakness, nausea and vomiting, increased salivation,difficulty in swallowing, and respiratory failure.Primary treatment is directed toward evacuatingthe stomach contents. If the victim has not vomited,cause him to do so. Use syrup of Ipecac, gastric lavage,or manual stimulation; then administer a cathartic. Ifrespiratory failure develops, give artificial ventilationand treat for shock.INHALATION POISONSIn the Navy, and in other industrial settings ingeneral, inhalation is the most common route ofexposure to toxic substances. The irritants andcorrosives mentioned in tables 5-2 and 5-3 are moreoften a source of poisoning by means of inhalationrather than by ingestion. An inhaled poison can actdirectly on the upper respiratory tract or lungs withimmediate, delayed, or chronic effects, or thesubstance can use the pulmonary system to gain entryinto the body, be absorbed into the blood, and causetoxic effects (systemic toxicity) at a distant site ofaction.The handling of large quantities of petroleumproducts (fuel oil and gasoline, in particular)constitutes a special hazard, since all of these productsgive off hazardous vapors. Other poisonous gases areby-products of certain operations or processes:exhaust fumes from internal combustion engines;fumes or vapors from materials used in casting,molding, welding, or plating; gases associated withbacterial decomposition in closed spaces; and gasesthat accumulate in voids, double bottoms, empty fuel5-7Toxin SourceC i g u a t o x i n( c h o l i n e r g i ceffects)tends to be found in fish from coralreefs, including barracuda, grouper,red snapper, parrot fishScombrotoxin(histamine-likereaction)tuna, bonito, skipjack, mackeral,mahi mahiSaxitoxin( n e u r o l o g i ceffects)bivalve shellfish (mussels, clams,scallops) accumulate toxin fromdinoflagellate during red tidescausing A paralytic shellfishpoisoning@*Tetrodotoxin(neurotoxin)*Neurotoxinbacteria found in puffer fish,California newt, eastern salamanderMoray eel* toxic at all timesTable 5-4.—Examples of Toxins from Fish Known to bePoisonousPUFFERTRIGGERFISHPARROT FISHPORCUPINE FISHFILEFISHSURMULLET OR GOATFISHSURGEONFISHHM3f0501Figure 5-1.—Poisonous fish.
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