Treat Jellyfish Stings

The good news is that jellyfish stings are rarely life-threatening. The bad news is that, when a jellyfish stings you, they release thousands of extremely small barbs that hook into your skin and release venom. Most of the time, this venom will cause slight discomfort or a painful red rash. In rare cases, jellyfish venom can result in illness throughout the body. If you or someone you know had the misfortune of being stung by a jellyfish, quick and decisive action will help you.

Steps

What to Do Right Away

1. Know when to call emergency services and seek immediate help. Most jellyfish stings do not require medical intervention. However, if you or someone else finds themselves in the following situations, seek immediate medical help:
   • The sting itself covers more than half your arm, half your leg, a large part of your torso, or your face or genitals.
   • The sting causes a severe allergic reaction, including but not limited to difficulty breathing, dizziness or light-headedness, nausea, or palpitations.
   • The sting came from a box jellyfish. Box jellies have extremely potent venom. They are found off the coast of Australia, and elsewhere in the Indo-Pacific, as well as Hawaii. They are pale blue in color and have a cube-shaped head, or "medusa." They can grow approximately 6 feet (2 meters) tall.
2. Get out of the water as calmly as possible. To head off the possibility of being repeatedly stung and to begin treatment, seek land as soon as you are stung.
   • As you get out of the water, try not to scratch the sting-site or touch it with your hands. There are likely still tentacles attached to your skin, and itching or touching them will only get you stung more.
3. Douse the tentacles liberally with vinegar for at least 30 seconds. Vinegar has been shown to inactivate the stinging cells from a diversity of species, and will make it so that no further harm comes from the tentacles , and it is recommended by health authorities.

Removing Jellyfish Tentacles from the Skin

1. Stay extremely still while you remove the tentacles. If you are experiencing shock, make sure that someone has called emergency services and try to calm yourself as much as possible. The more you move around while you attempt to remove jellyfish tentacles, the more venom will be released.
   • Tweezers, a knife, or a pair of clean sticks may be helpful in removing the venom-filled tentacles. Do not attempt to rub or scrape the tentacles, as this will cause more stinging cells to fire.
2. Throw away any materials that came in contact with the jellyfish nematocysts. Drive down to 0% the likelihood that you'll accidentally sting yourself again.
3. Once the tentacles have been removed, relieve pain with painkillers or by immersing the stung area in hot water (not scalding!). Studies have shown that heat inactivates the venom toxins, relieving pain better than ice If you are experiencing extreme pain, take a recommended dose of a painkiller, such as paracetamol or ibuprofen.

What Not to Do

1. Don't try to treat jellyfish stings with urine. The idea that urine was a good treatment for jellyfish stings probably originated as an old wives' tale, and then entrenched itself even further after a Friends episode used it for comedic effect. There's no need to pee on your jellyfish sting!
2. Avoid applying fresh water to the sting. Most jellyfish stings occur in saltwater. That means that the nematocysts have large concentrations of saltwater in their venom cells. Any change to the solution of saltwater in the nematocysts will cause the venom cells to fire. Fresh water does just this. Stick with saltwater instead.
3. Don't use meat tenderizer to deactivate stingers. There isn't any research indicating that it actually works, and it may cause more harm than good.
4. Know that alcohol applied directly to the skin may backfire. Like adding a freshwater solution to the skin, alcohol may actually cause the nematocysts to discharge even more venom, leading to a more painful experience.

Treating Discomfort and Following Up

1. Clean and bandage any open sores. After you've removed the tentacles and relieved most of the lingering pain, clean the affected area with warm water. (It doesn't need to be saltwater, as the nematocysts — which react with the fresh water — should have already been removed.) If the skin is still visibly irritated or raw, lightly cover the area with a bandage and wrap with gauze.
   • Three times a day, clean the area with warm water and apply an antibiotic ointment like Neosporin. Then wrap the area with a bandage and gauze.
2. Use oral and topical antihistamines to relieve itching and other irritated skin. Soothe any remaining skin irritations with over-the-counter antihistamine pills, or with topical creams containing diphenhydramine or calamine.
3. Wait a full day for the pain to subside and several days for the irritation to go away. 5 - 10 minutes after treatment, the pain should begin to lessen. After a full day, the pain should be almost completely gone. If you continue to experience pain past a full day and haven't done so already, see a doctor or specialist for professional treatment.
   • In rare cases, stings from jellyfish can cause either infection or scarring, but most people avoid these scenarios entirely, even after especially painful stings.
   • In extremely rare cases, people experience hypersensitivity to the venom a week or several weeks after being stung. Blisters or other skin irritations may surface seemingly out of the blue. While this hypersensitivity is generally not dangerous, it may be helpful to see a doctor or dermatologist for assistance.

Tips

• Regarding the meat tenderizer, vinegar, alcohol and urine treatments, literature gives conflicting reports on the effectiveness of these treatments. Common sense suggests that they only be used as last resorts. If they are used, start by treating a small area. If the pain worsens, discontinue the treatment and consult a doctor. The varying degrees of effectiveness of meat tenderizer may be due to the different enzymes in different brands. The most effective enzyme is papain, (papaya enzyme.) The enzyme breaks down the proteins that make up nematocysts, which inject poison, turning them into harmless amino acids.
• After initial treatment, hot water, as hot as you can stand, will give you temporary relief from pain.
• Involve lifeguards if there are any. Local lifeguards will likely have experience with jellyfish stings and will have the necessary supplies and skills to treat the stings quickly and effectively.
• Many times the victim will not see what creature did the stinging. If symptoms persist or worsen, seek medical attention after being stung by any marine creature.
• Depending on the type of jellyfish that caused the sting and the severity of the sting, a variety of treatments may be employed. If the sting was from a box jellyfish, antivenin may be administered to neutralize the venom. If the sting caused loss of heart function, CPR will be administered and an epinephrine injection may be required.
• Some deadly box jellyfish are found in the ocean around Australia and some parts of Hawaii. You have virtually no chance of surviving its venomous sting, unless treated immediately. The pain is excruciating and overwhelming. After neutralizing and removing stingers, artificial respiration and cardiac massage may be required. Where antivenin is unavailable, pressure-immobilization may be used on limbs after inactivation of stinging cells, while the patient is being transported to the nearest medical center. Not all box jellies are deadly however.

Warnings

• Do not apply any of these solutions into or around the eyes. Dip a clean towel or cloth into the solution and dab around the eyes.
• Never rub the tentacles off, as it will cause even more pain. Instead, pull them off.
• Do not leave meat tenderizer on the skin for more than 15 minutes.
• Vinegar is not recommended for Portuguese man o' war (a deadly jellyfish) stings.

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