First Aid Response for Tetrodotoxin Poisoning
Initial symptoms following tetrodotoxin (TTX) poisoning can include numbness around the mouth, tingling, pricking of the skin and nausea. In severe cases, paralysis rapidly advances with respiratory problems first appearing as difficult or laboured breathing. Reduced blood pressure, fixed dilated pupils and widespread paralysis follows, which may progress to breathing muscle paralysis and an inability to breathe. An irregular heartbeat may also occur.
Due to the rapid onset of life threatening effects, quick and appropriate initial management will be crucial. Prompt and sustained pulmonary resuscitation (PR) – mouth-to-mouth breathing - is essential. However, because of the risk of further poisoning, the resuscitator should wash thoroughly around the patient’s mouth area first. Chest compressions are not needed unless a pulse is absent. Although vital signs may suggest the patient is either unconscious or dead, they will remain fully aware of their circumstances and can hear the conversations of those providing support. Mouth-to-mouth must continue until the ambulance arrives. Ambulance staff can stabilise the patient and provide more advanced PR support.
