Irukandji Syndrome: A critique of current nursing management at The Townsville Hospital Emergency Department

Abstract

Summary Background Irukandji Syndrome is caused by a potentially lethal jellyfish envenomation. Despite the low incidence, the condition is associated with possible life-threatening cardiovascular complications that make it difficult to manage in emergency departments. Managing Irukandji Syndrome is important for many emergency departments across Australia, particularly in North Queensland, the Northern Territory, and Western Australia. Methods The aim of this quality project was to identify current management, practices and nursing knowledge in the only emergency department in the regional city of Townsville, Queensland. This was undertaken via chart audit of all presentations over a 2-year period and a survey of nursing staff. Results Fifteen cases of Irukandji Syndrome were identified. Medical treatment options included use of opioids and magnesium for symptom control. Magnesium as a treatment option was used in 80% of cases. Chart audit indicated that in 20% of cases nursing management did not follow approved clinical guidelines for treatment and monitoring. The survey of nursing staff indicated a knowledge deficit with respect to the signs and symptoms of Irukandji Syndrome, standards of clinical monitoring, clinical assessment, and overall care provided. Conclusions To improve care of Irukandji Syndrome in the emergency department, in-service education, implementation of tendon reflex assessment for patients receiving magnesium therapy, and the development of a specific clinical documentation are recommended.