Connect
MJA
MJA

Are we using the correct first aid for jellyfish?

Jamie E Seymour
Med J Aust 2017; 206 (6): 249-250. || doi: 10.5694/mja17.00053

The answer is predicated on our knowing what the correct treatment is — and we don’t

In this issue of the MJA, Isbister and colleagues report that hot water immersion was no more effective than ice packs for treating the pain of stings by the box jellyfish (Chironex fleckeri).1 This finding is surprising, as jellyfish venoms are heat-labile,2 but unsurprising, given that heat treatment for some patients did not begin until 4 hours after the patient was stung.

Please login with your free MJA account to view this article in full

  • Jamie E Seymour

  • Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, QLD

Correspondence: Jamie.Seymour@jcu.edu.au

Competing interests:

No relevant disclosures.

  • 1. Isbister GK, Palmer DJ, Weir RL, Currie BJ. Hot water immersion v icepacks for treating the pain of Chironex fleckeri stings: a randomised controlled trial. Med J Aust 2017; 206: 258-261.
  • 2. Carrette T, Cullen P, Little M, et al. Temperature effects on box jellyfish venom: a possible treatment for envenomed patients? Med J Aust 2002; 177: 654-655. <MJA full text>
  • 3. Australian Resuscitation Council. Envenomation: jellyfish stings (guideline 9.4.5) July 2010. https://resus.org.au/?wpfb_dl=41 (accessed Feb 2017).
  • 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. <MJA full text>
  • 5. Hartwick R, Callanan V, Williamson J. Disarming the box-jellyfish: nematocyst inhibition in Chironex fleckeri. Med J Aust 1980; 1: 15-20.
  • 6. Welfare P, Little M, Pereira P, Seymour J. An in-vitro examination of the effect of vinegar on discharged nematocysts of Chironex fleckeri. Diving Hyperb Med 2014; 44: 30-34.
  • 7. Carrette TJ. Etiology of Irukandji Syndrome with particular focus on the venom ecology and life history of one medically significant carybdeid box jellyfish Alatina moseri. Thesis: James Cook University, Cairns, 2014. http://researchonline.jcu.edu.au/40748/ (accessed Feb 2014).
  • 8. Seymour JE, Carrette T, Cullen P, et al. The use of pressure immobilization bandages in the first aid management of cubozoan envenomings. Toxicon 2002; 40: 1503-1505.
  • 9. Pereira P, Carrette T, Cullen P, et al. Pressure immobilisation bandages in first aid treatment of jellyfish envenomation: current recommendations reconsidered. Med J Aust 2000; 173: 650-652. <MJA full text>
  • 10. Corkeron MA. Magnesium infusion to treat Irukandji syndrome. Med J Aust 2003; 178: 411. <MJA full text>
  • 11. McCullagh N, Pereira P, Cullen R, et al. Randomised trial of magnesium in the treatment of Irukandji syndrome. Emerg Med Australas 2012; 24: 560-565.
  • 12. Winter KL, Isbister GK, McGowan S, et al. A pharmacological and biochemical examination of the geographical variation of Chironex fleckeri venom. Toxicol Lett 2010; 192: 419-424.
  • 13. Kintner AH, Seymour JE, Edwards SL. Variation in lethality and effects of two Australian chirodropid jellyfish venoms in fish. Toxicon 2005; 46: 699-708.
  • 14. Underwood AH, Seymour JE. Venom ontogeny, diet and morphology in Carukia barnesi, a species of Australian box jellyfish that causes Irukandji syndrome. Toxicon 2007; 49: 1073-1082.
  • 15. Boulware DR. A randomized controlled field trial for the prevention of jellyfish stings with a topical sting inhibitor. J Travel Med 2006; 13: 166-171.

Author

remove_circle_outline Delete Author
add_circle_outline Add Author

Comment
Do you have any competing interests to declare? *

I/we agree to assign copyright to the Medical Journal of Australia and agree to the Conditions of publication *
I/we agree to the Terms of use of the Medical Journal of Australia *
Email me when people comment on this article

access_time 11:38, 24 May 2017
John Rederje

Any method of heating works quite well on jellyfish: a simple hair dryer blows hot with the right temperature 45°C i.e. around 125°F, miraculous, your blisters disappear, not too hot to burn your skin, but breaking down the venom in a few seconds and suppressing any pain, any blisters, and preventing scars in the following days. A simple hot sheet of paper works, but hot water needs an accurate temperature thermometer to be sure to be below 50°C to not burn heavily your skin and to be around 45°C to break down the venom, labile with moderate heat, applied as soon as possible. These simple methods, sea water, a simple hot black paper heated in the sun or with a magnifying glass, cigarette, hair dryer, etc.. .
I and my wife, we used successfully this method for many around 100 jelly fish stings over the last 15 years !
Any others methods are inefficient, with pain over several days and scars many years laters sometimes, before we used a simple hot Hair dryer or a hot sheet of paper .

Competing Interests: No relevant disclosures

Dr John Rederje
CEA

Responses are now closed for this article.