![]() The stonefish, a member of the subfamily Synanceinae, is most commonly encountered in the Indo-pacific region, although a few species are reported in the Caribbean Sea and waters of the Florida Keys. Although they often pose a threat as aquarium occupants, they typically cause injuries when caught by fishermen or encountered by divers. Scorpionfish are less aggressive than the lionfish but are much more camouflaged (see figure 1). ![]() The scorpionfish belongs to the subfamily Scorpaeninae which, like the lionfish, is native to the Indo-pacific coastal waters but can be found westward off the coast of California down to South America and eastward off the coast of North Carolina through the Caribbean down to Brazil. Many divers hunt lionfish as a service to the health of the reef, but this should be done very carefully wearing gloves and other protective gear to avoid getting pierced by the spines. It is important for divers in these areas to recognize and avoid skin contact with lionfish due to the consequences of their envenomation. As a result, 2 of 15 species of Pteroinae, including the common lionfish ( Pterois miles), are well-established across the east coast of the United States posing a monumental threat to coral reef life in the Caribbean. ![]() The first, red lionfish ( Pterois volitans) was likely introduced off the coast of Florida around 25 years ago. The lionfish is considered one of the most threatening, invasive species in the Atlantic Ocean. They are prized aquarium fish because of their beautiful, yet foreboding, coloration and whimsical fins and rays, which contain the spines. However, it is more commonly encountered by aquatic fish tank handlers across the United States who try to hand-feed, transfer, or catch the fish. ![]() The lionfish belongs to the subfamily Pteroinae and is native to the Indo-pacific coastal waters. Understanding the distribution of these fish, their appearance, the injuries they cause, and management is important for physicians and patients at risk. Stonefish are bottom-feeders that cause injury when they are stepped on, commonly in the coastal waters of Australia, Indonesia, and India. Scorpionfish are commonly encountered by divers or fishermen and often injure the hands of those who touch them. Lionfish are common residents of aquariums and typically injure the fingers and hands of those who handle the fish. These spines are encapsulated by glandular venom-producing integumentary sheaths that release venom when mechanically disrupted through contact with a victim. All of these fish possess spines on their dorsal, pelvic, and anal fins. The family is subclassified by the morphology of the venomous spines of the fish into 3 major subfamilies, the lionfish, scorpionfish, and stonefish. The family Scorpaenidae includes the most venomous fish in the ocean and, next to the stingray, are responsible for the most marine envenomations annually. In fact, more than 50% of venomous vertebrates are fish. Venomous fish are a threat to divers across the world. This activity reviews the evaluation and management of lionfish, scorpionfish, and stonefish envenomation and highlights the role of interprofessional team members in collaborating to provide well-coordinated care and enhance outcomes for affected patients. Stonefish are bottom-feeders commonly found in the coastal waters of Australia, Indonesia, and India that cause injury when they are stepped on. Scorpionfish are commonly encountered by divers or fishermen and likewise, often injure the hands of those who touch them. Lionfish are common residents of aquariums and commonly injure the fingers and hands of those who handle them. Lionfish, scorpionfish, and stonefish are members of this family. The family Scorpaenidae includes the most venomous fish. More than 50 percent of all venomous vertebrates are fish, and which pose a threat to divers around the world.
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