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Post Info TOPIC: Gympie-Gympie stinging tree causing hospitalisations in Far North Queensland


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Gympie-Gympie stinging tree causing hospitalisations in Far North Queensland


Gympie-Gympie stinging tree causing hospitalisations in Far North Queensland:

https://www.abc.net.au/news/2023-03-23/qld-stinging-tree-gympie-gympie-far-north-queensland/102125176

Naomi Lewis has given birth to four children, but nothing prepared her for the excruciating and long-lasting pain of an encounter with a venomous stinging tree in Queensland's far north.

She was mountain biking at Smithfield, near her Cairns home, when she came off her bike, left the trail and hurtled down an embankment, sliding into a stinging tree, known colloquially as a Gympie-Gympie plant.

The 42-year-old said the pain on both her legs -- from where her shorts finished -- was "100 per cent the worst pain ever", describing the sensation as feeling like she had been set on fire.

 


-- Edited by dorian on Thursday 23rd of March 2023 02:11:39 PM

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We have several stinging trees growing not too far from the house we are living in. The ones here, known as the Iron Range Stinging Tree are similar to the Gympie Gympie & others further south, but is renowned for being the most toxic & more painful than any of the others.  Even contact with dead plants which have been laying on the ground for long periods have the same effect. They are among few of the worlds venomous plants, injecting neurotoxins into the 'victim'. Interestingly though whilst causing extreme pain they do not actually damage the body like many other venoms. eg. from some snakes. 

A significant problem is that to the untrained eye there are many harmless plants which look quite similar.

Effects can continue for many months, but it is the first 24 hours which are worst & when opiate medication is required

Last year we had an incident where a young researcher visiting was badly stung on his arm, the result of casually brushing against the plan't leaves whilst walking in the rainforest. Falling into the plant like the lady in the article would have been absolutely horrific, almost unimaginable. 

The following is an extract from one if my blog posts last year. 

"It was whilst they were here that the stinging tree incident occurred. Pedro, the 6 tall young team leader described feeling his arm brush against what felt like sandpaper. Moments later the pain began. Back at the house his arm became swollen & oozing clear fluid. Pain came in waves affecting his lymphatic system, not just the injured area. He was a stoic chap, not given to theatrics, not wanting to give into the substantial pain he was in, but as it worsened we could see it in his face. The Iron Range Stinging tree, which is an opportunistic plant, popping up where light gaps are created, along side paths or where cyclones have brought trees down, generally lasting until the canopy above heals itself, is considered to be the most painful of several species of stinging tree across Australia. It is a little understood plant, with two attempts to research it over the 30 years abandoned due it making the researchers sick. A further more recent attempt to understand it has described it as a venomous plant which effectively injects, as yet not understood neurotoxins into its victims. A treatment protocol from Cairns base hospital was found online.  Click on link below

http://c-foam.com.au/wp-content/uploads/2018/04/ARCS-Tox-Stinging-Tree-Management.pdf     (NOTE: This link no longer works but I have copied it below in the post).

From this it was obvious that we were dealing with a poorly understood situation, based upon anecdotal aboriginal records of crushing ants to obtain formic acid to put onto the wound. 

The tree, on touching the skin leaves tiny silica hypodermic like needles, in the skin which when disturbed release more toxins.  Pedro had hairy arms & the first thing he did was to shave the affected area releasing more toxins. His colleagues, using what they had to hand, then applied duct tape to pull out the micro needles, but probably did more harm than good pressing the duct tape onto his skin. 

Finally he recognised that he could not tough it out and accepted my offer to take him into the clinic. We felt confident that the clinic would be familiar with the situation & it was one of the three days per week that the RFDS staff were there. Is that the tree which leaves prickles in you asked the visiting RFDS male nurse. This did not inspire confidence. After the nurse had looked in the book (not the management protocol we had found online) he decided that spreading a topical painkiller, Lignocaine gel, on the affected site was the best strategy. Mere touch of Pedros skin was agony, a breeze through the room was more than enough, let alone a spatula & gel. With gritted teeth & a more than sweaty brow he asked me to see if I could find some hydrochloric acid (as per the online management protocol), something the clinic did not have. I found some at the council hardware store, lots of it in 20 litre drums.  Opening a drum one could see the acrid corrosive fumes immediately rise into the air. After stopping the young shop assistant from trying to pour some into a handy narrow necked soft drink bottle, direct from the drum with no funnel, no gloves, no protective glasses a major burns victim in the making, I returned to the clinic & obtained a large syringe & a urine specimen jar before returning to get the acid a little more safely, albeit still with no protective wear.  Back at the clinic once more, with the knowledge that we now had the acid (& which the clinic were not prepared to administer Itll be at your own risk you know) Pedro used a tap to wash off the lignocaine. The moment the room temperature water touched his skin his knees buckled & a groan escaped his mouth, the only time I heard him do so. He left the hospital with a showbag of goodies. Gauze swabs, more lignocaine, pain killers (Endone), laxative tablets to be taken with the endone, syringes, sterile water etc. Back at the house we diluted the 33% hydrochloric acid to 3.3% & with swabs over the affected area Pedro carefully squirted acid onto them from a syringe & left them in situ for 20 minutes. I was terrified he would be causing himself severe burns, but accepted his logic of rather risk burns than leave this as it is. The theory was that the acid would aid in dissolving the silica needles.  This was repeated twice more during that day. By late afternoon he was still in a bad way & feeling increasingly desperate. Some other online sources had suggested using hydrochloric acid at 10%.  Pedro felt he needed a stronger solution as the 3.3% had had little to no effect. He suggested 6.6% as this would make for easier & more accurate dilution. So we tried it. Thankfully no acid burns & it helped. An endone aided sleep overnight & the following day although still very sore, he was over the worst of it. The effects last for months, but the first 24 hours are by far the worst. We now have a kit made up here just in case, with 6.6% hydrochloric acid to be used as the first step, followed by the poured (not spread) application of hair removal wax, before going to the clinic to seek serious painkillers. 

 

CAIRNS HOSPITAL EMERGENCY DEPARTMENT STINGING TREE MANAGEMENT PROTOCOL

There are no good studies of Stinging tree injury management. The information in this document is obtained from Cape Tribulation research group Austrop and from clinical experience in Cairns. The use of acid is based on indigenous treatment of stinging tree using crushed green ants (ie formic acid).

Stinging trees

There are a number of species of the family Denrocnide in eastern Australia. Their leaves are large heart shaped and are covered in fine silica hairs which contain a poorly described polypeptide toxins that release acetylcholine, histamine, 5HT and neuropeptides.

Contact with these hairs causes severe pain which has been reported to last, untreated, for up to 2 months.

How to make 3.3% hydrochloric acid (HCl)

  1. Buy 5L 10% HCl from hardware store

  2. Mix 2/3 water with 1/3 HCl = put acid into water

Treatment of stinging tree stings

A stinging tree kit contains: Hydrochloric acid diluted to 3-4 % Waxeze
Local anaesthetic (LA) gel

Treatment protocol:

  1. Prescribe adequate analgesia, often opiates will be required

  2. Place chlorsig (you could use white paraffin) around sting site

  3. Soak gauze with the 3.3% acid solution and place gauze over sting site (warn the patient the pain may worsen initially)

  4. Leave for 20 mins

  5. If necessary repeat for 20 mins

    Unless a minor sting, move onto delipation:-

  1. Depilation by application of Waxeze onto a cloth and then the skin. Avoid smearing the wax on the skin as this will cause more pain.

    Allow the wax to warm and settle around the stings. Pull off the Waxeze
    If this fails to resolve pain:-

  2. Apply topical anaesthetic gel after wax removal

Note: Children may require procedural sedation to effect the treatment.
Assistance should be sought from the ED Orange Consultant, or in consultation with the Toxicology Team.

Discharge

On discharging patient, warn pain may recur and last for weeks Use oral analgesia +/- LA gel.



-- Edited by Cuppa on Thursday 23rd of March 2023 03:53:24 PM



-- Edited by Cuppa on Thursday 23rd of March 2023 03:55:15 PM

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I have a vague memory of a local (myth?) treatment based on using the sap of a broad shiny leafed, lily like plant that is usually found close to the stinging tree.

Fortunately, I have never had the need to try out this 'remedy'.



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I am thinking out loud here

When we come across such a tree, why don't we destroy it?

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Tony Bev wrote:

I am thinking out loud here

When we come across such a tree, why don't we destroy it?


 I can only answer that from our perspective. Basically 'risk avoidance'. 

It can sting through clothing as well as contact with bare skin which makes cutting it down problematic. Any part of the plant can sting, not just the leaves. Stems & fruit too. 

It can also lay dead, brown & shrivelled on the ground, unrecognisable, & still sting just as badly. 

We did cut down a small plant which was only a couple of feet high when we discovered it, using long pole type secateurs, & where we could easily drop the cut plant near to where it had grown, but in a position where no-one was likely to walk. 

Larger plants (close to 3 metres with multiple stems) are rather more daunting, plus we feel safer knowing where they are in order to avoid them. 

First pic shows one of our two known plants with 'fruit'. Because leaves often vary in size & can be easily confused with any number of other similar looking plants, knowing what the fruit looks like is helpful - although not foolproof as they don't always have fruit on them, It is also very common for them to look quite 'moth eaten by insects like this one.

Stinging tree.jpeg

 However this, our second known plant always looks in far 'better' condition. 

Stinging tree (1).jpeg



-- Edited by Cuppa on Wednesday 29th of March 2023 01:07:35 PM

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interesting bit of information, handy to know

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