What is the treatment for a jellyfish sting?

Treatment for Jellyfish Stings

The immediate treatment for jellyfish stings should include decontamination with vinegar (4-6% acetic acid solution) for at least 30 seconds, followed by rinsing with seawater and immersion in hot water (approximately 40°C/104°F) for 20-30 minutes for pain management. 1

Initial Management Protocol

1. Immediate Decontamination:

   • Apply vinegar (4-6% acetic acid solution) for at least 30 seconds to inactivate remaining nematocysts 1
   • Rinse with seawater, NOT fresh water 1
   • AVOID using fresh water, alcohol, methylated spirits, or folk remedies (including urine), as these can trigger additional nematocyst discharge 1, 2

2. Tentacle Removal:

   • Remove remaining tentacles by carefully lifting or pulling them while avoiding direct skin contact 1
   • If mechanical removal isn't possible, rinse with seawater 1
   • DO NOT scrape the area as this can trigger additional nematocyst discharge 1

3. Pain Management:

   • Immerse the affected area in hot water (as hot as tolerated, approximately 40°C/104°F) for 20-30 minutes 1
   • Alternative options if hot water is unavailable:
     • Dry hot packs 1
     • Topical lidocaine cream/gel (4-5% or 10-15% formulations) 1

Wound Care

• Clean the wound daily with warm potable water with or without soap 1
• Apply antibiotic ointment or cream 1
• Cover with a clean occlusive dressing 1
• Debride any necrotic tissue and remove visible foreign bodies 1
• Monitor for signs of infection 1

When to Seek Emergency Care

Monitor for systemic reactions requiring emergency medical attention:

• Difficulty breathing
• Signs of shock
• Severe pain
• Anaphylactic reactions (rare but documented) 1, 3

Important Cautions

• DO NOT USE:
  • Pressure immobilization bandages 1, 2
  • Fresh water 1, 2
  • Alcohol or methylated spirits 1, 2
  • Aluminum sulfate 1
  • Meat tenderizer 1
  • Folk remedies like urine 1

Special Considerations

• Treatment may need to be species-specific in some cases, particularly for dangerous species like the Australian box jellyfish (Chironex fleckeri) 4
• While the American Heart Association recommends hot water for pain management 1, there is some debate about whether cold packs may be more appropriate for tropical jellyfish species 4
• For severe envenomation from dangerous species, stabilizing vital functions takes priority 2

Prevention

• Wear protective equipment when swimming in risky areas 2
• Pay attention to beach warning signs about jellyfish risk 2

The evidence supporting vinegar and hot water treatment is of moderate strength 1, though some research suggests more studies are needed to establish definitive species-specific guidelines 4, 5.