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TREATMENT OF MARINE STINGS
In the Tropical North where fatal stings occur, the priorities for sting treatment are, in this order:
These priorities are normally written as:
What to expect for a box jellyfish sting:
The victim will be in an enormous amount of pain, and quite possibly hysterical and uncontrollable. The tentacles will likely still be on the victim, appearing as tapeworm-like ribbons. The sting marks will look like whip-marks, swollen, red; within a few minutes the marks will go frosty white as the skin dies.
Try to keep the victim calm, and get help urgently (call '000' for an ambulance, or send someone to get a Lifesaver). Anyone giving care to a box jellyfish victim should anticipate that the victim may lose conciousness and require urgent CPR (Cardio-Pulmonary Resuscitation) - without CPR, they are unlikely to survive. Stings covering more than 1/2 of one limb (or equivalent) are considered life threatening. Do not use compression bandages.
Contact stings to the caregiver will be painful but will not be life-threatening, due to the small amount of exposure. Flood the sting area with vinegar as soon as possible to neutralise remaining stinging cells, to stop more venom from being injected into the victim. If you are presented with a choice of going to get vinegar or commencing CPR, commence CPR -- it is better to have a living patient with more venom than to have a dead patient that has been vinegared (if they have lost conciousness, they already have enough venom in their body to kill them).
What to expect for an Irukandji sting:
The initial sting will be minor, feeling like sea lice or a scratchy, pin-stabbing feeling at the most; many victims do not feel the sting at all. Often there is no mark; if present, it may look like a small area of goose-pimples, small red dots, a lash-like line, or a blotchy reddened area. Often the sting area will sweat profusely.
After about 20-30 minutes (but may onset in 5-40 minutes), the victim will begin feeling severe lower back pain, and may feel any or all of the following: nausea, vomiting, sweating, difficulty breathing, full-body cramps, limb spasms, coughing, and a feeling of 'impending doom'. Some cases may involve an extremely high blood pressure (hypertension) component, which is believed to be species-related.
It is important for any suspected Irukandji sting, or any sting of unknown origin, to douse with vinegar as early as possible to neutralise remaining stinging cells - they are microscopic, but they will keep injecting more venom until vinegar is applied.
An Irukandji victim is unlikely to require CPR (Cardio-Pulmonary Resuscitation), but should be monitored for difficulty breathing and loss of conciousness. Help should be sought urgently - Irukandji syndrome is treatable in hospitals and clinics.
Treatments such as ice or hot water may make the sting worse. Freshwater will cause more stinging cells to discharge, injecting more venom into the victim. Furthermore, heat may dilate capillaries, enhancing both the speed and quantity of venom uptake.
What to expect for a blue bottle sting:
The pain will be instant and sharp, and linear welts will be present, with or without a beaded appearance. Often blue tentacles will still be present on the skin, and can be picked off by hand or with forceps.
Treatments such as ice or hot water may be used; the freshwater will cause more stinging cells to fire more venom into the skin, but it is not considered life-threatening. Vinegar will neutralise the stinging cells of the common single-tentacled blue bottle, but may cause discharge in the larger multi-tentacled blue bottle from Queensland. Therefore, to avoid complication, vinegar is not generally recommended for known blue bottle stings. Rinsing the sting area well with seawater is the best way to remove any remaining stinging cells from a blue bottle.
Generally, blue bottle stings self-resolve in about a half hour; however, some species of blue bottles give an Irukandji-like syndrome, and require medical care. Any sting event involving difficulty breathing, loss of conciousness, or unresolved pain should seek medical care.
What to expect for other jellyfish stings:
There are hundreds of species of jellyfish in Australian waters, and all of them sting to some degree or another. In most cases, the sting marks and pain are minor, and will self-resolve in a matter of minutes. However, in tropical waters where life-threatening jellyfish are more prevalent, seemingly minor stings should be doused with vinegar and the victim should be monitored for about a half hour, as the sting may develop into Irukandji syndrome (see above). Irukandjis occur outside the tropics, but much more rarely.
Copyright © 2011 Australian Marine Stinger Advisory Services. All rights reserved. Page modified 8 August, 2011 10:41