Manage pain with 4-5% acetic acid (household vinegar) & Hot water immersion (111-114F)
Fentanyl IV or other opiate for pain.
IV magnesium sulfate (0.2mmol/kg, max 10mmol in adults) given as a bolus over 5-15 minutes for pain refractory to opioids
Hypertension should be treated with short-acting titratable medications (eg., nitroglycerin, phentolamine, esmolol, nicardipine, nitroprusside) due to potential for hypotension in the later stages of toxicity
Irukandji syndrome
Toxins
Twiddler's syndrome
Ciguatera
Horner syndrome
Scombroid
Bell's palsy
Tetrodotoxin 