Treatment

Treatment

The three goals of first aid for uncomplicated stings

•  to prevent injury to rescuers, 
• deactivate the nematocysts, 
• and remove tentacles attached to the patient.

 Rescuers usually wear barrier clothing, such as pantyhose, wet suits or full-body sting-proof suits while removing jellies or tentacles from injured. Deactivating the nematocysts (stinging cells) prevents further injection of venom.

Vinegar (3–10% aqueous acetic acid) may be used as a common remedy to help with box jellyfish stings,^[1][2] but not the stings of the Portuguese Man o' War (which is not a true jellyfish, but a colony).^[1] For stings on or around the eyes, a towel dampened with vinegar may be used to dab around the eyes, with care taken to avoid the eyeballs. Salt water may be used as an alternative if vinegar is unavailable,[1][3]  and may be preferred over vinegar.^[4]Fresh water is not usually used if the sting occurs in salt water, as changes in tonicity^[5] can release additional venom. Rubbing wounds, or using alcohol, spirits, ammonia, or urine may have strongly negative effects as these can encourage the release of venom.^[6]

Clearing the area of jelly, tentacles, and wetness further reduces nematocyst firing.^[6] Scraping the affected skin with a knife edge, safety razor, or credit card may remove remaining nematocysts.^[6]

Beyond initial first aid, antihistamines such as diphenhydramine (Benadryl) may control skin irritation (pruritus).^[7] Ice or fresh water is not usually applied to stings, since they may cause nematocysts to continue to release toxin.^[8][9] Immunobased antivenins have been available since the 1970s;^[10] administration requires medical personnel and refrigeration and are used in extreme cases as with regard to the box jellyfish, Chironex.^[11]

References

1.  Fenner P, Williamson J, Burnett J, Rifkin J (1993). "First aid treatment of jellyfish stings in Australia. Response to a newly differentiated species". Med J Aust 158 (7): 498–501. PMID 8469205.
2.  Currie B, Ho S, Alderslade P (1993). "Box-jellyfish, Coca-Cola and old wine". Med J Aust 158 (12): 868. PMID 8100984.
3. Yoshimoto C; Leong, Fui-Ming; Rudloe, Jack (2006). "Jellyfish species distinction has treatment implications". Am Fam Physician 73 (3): 391. PMID 16477882
4.