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Bites and stings

Treatment of jellyfish stings

John G Taylor
MJA 2007; 186 (1): 43

To the Editor: An experiment was recently conducted during a morning doctor’s seminar at the Busselton Hospital to assess four treatments for jellyfish stings using specimens of Carybdea species collected from the nearby waters of Geographe Bay.

Two doctors and three medical students consented to participate. The tentacles of the jellyfish were dragged over the moistened forearm, producing two well separated stings on each forearm. After 5 minutes, there were visible red wheals developing at the sting sites. Four different treatment modalities were then tried, one at each sting location: ice, vinegar, aluminium sulfate, and hot water at about 45°C.

The participants were asked to assess the degree of pain relief given by the treatment, and the time taken to achieve that pain relief (Box). Hot water was the only successful treatment, relieving 88% of the pain; all participants obtained significant relief in 4–10 minutes. Other treatments were incomplete and temporary. Hot water was later used to treat the other stings.

It was also noted that the palpable wheals disappeared when hot water was used. This suggests that, in addition to relieving the pain, the heat treatment was stopping the inflammatory reaction.

Heat has been advocated as a treatment for fish spine envenomations from various species, and early application of heat has been found to prevent long-term sequelae.1,2

I have previously reported my experiences with stings from the large tropical jellyfish Tamoya gargantua.3 Application of heat led to the relief of pain over 10–15 minutes. Loten et al recently reported the use of hot water in treating bluebottle Physalia physalia stings, and suggested the mechanism was through heat inactivation of the jellyfish toxin.4

There is an urgent need for knowledge of this simple remedy to be spread, and there is the potential that it could even be lifesaving when used with more serious jellyfish stings in the north of Australia.

Degree of pain relief for the five participants (1–5) after various treatments for jellyfish sting

Pain relief during treatment


Continuing relief after treatment


Treatment

1

2

3

4

5

Mean

1

2

3

4

5

Mean


Ice

40%

0

75%

10%

0

25%

0

0

0

10%

0

2%

Vinegar

30%

0

20%

0

0

10%

0

0

20%

0

0

4%

Aluminium sulfate

75%

20%

30%

35%

50%

42%

0

20%

0

35%

50%

21%

Hot water

90%

95%

90%

80%

85%

88%

90%

95%

90%

80%

85%

88%


0 means no relief of pain; 100% means complete relief of pain. The pain relief was temporary (pain returned when treatment stopped) for all except hot water and (to a lesser extent) aluminium sulfate.

John G Taylor, General Practitioner

Busselton, WA.

jaqtaylATbigpond.net.au

  1. Edmonds CE. Dangerous marine animals of the Indo-Pacific region. Newport: Wedneil, 1975: 79-106.
  2. Taylor G. Toxic fish spine injury: lessons from 11 years experience. SPUMS J 2000; 30: 7-8.
  3. Taylor G. Are some jellyfish toxins heat labile? SPUMS J 2000; 30: 74-75.
  4. Loten C, Stokes B, Worsley D, et al. A randomised controlled trial of hot water (45°C) immersion versus ice packs for pain relief in bluebottle stings. Med J Aust 2006; 184: 329-333. <eMJA full text> <PubMed>

(Received 20 Sep 2006, accepted 26 Oct 2006)

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©The Medical Journal of Australia 2006 www.mja.com.au PRINT ISSN: 0025-729X ONLINE ISSN: 1326-5377