What is the treatment for a jellyfish sting?

Treatment for Jellyfish Sting

For jellyfish stings, immediately decontaminate the area with vinegar (4-6% acetic acid solution) for at least 30 seconds to inactivate remaining nematocysts, then immerse the affected area in hot water (as hot as tolerated, approximately 40°C/104°F) for 20-30 minutes for pain management. 1

Initial Management

1. Remove from water and ensure safety

2. Decontaminate the wound:

   • Apply vinegar (4-6% acetic acid solution) liberally for at least 30 seconds 1
   • If vinegar is unavailable, use baking soda slurry 2
   • Rinse with seawater (NOT fresh water) 1
   • Carefully remove any visible tentacles without scraping the skin 1

3. Pain management:

   • Immerse in hot water (as hot as tolerated, approximately 40°C/104°F) for 20-30 minutes 2, 1
   • If hot water is unavailable, use dry hot packs 2
   • Topical lidocaine (4-5% or 10-15% formulation) can be applied for localized pain relief 1, 3

What to Avoid

• DO NOT use:
  • Fresh water (triggers additional nematocyst discharge) 1, 4
  • Alcohol or methylated spirits 1, 4
  • Pressure immobilization bandages (causes further venom release) 2, 1
  • Meat tenderizer or aluminum sulfate 2, 1
  • Scraping the area (can trigger additional nematocyst discharge) 1

Follow-up Care

1. Wound care:

   • Apply antibiotic ointment or cream 1
   • Cover with clean occlusive dressing 1
   • Monitor for signs of infection 1

2. When to seek emergency care - if the patient develops:

   • Difficulty breathing
   • Signs of shock
   • Severe pain
   • Systemic symptoms 1

Species-Specific Considerations

Treatment efficacy may vary depending on jellyfish species. While vinegar is generally recommended, it may cause pain exacerbation in some North American species 5. Hot water immersion appears more universally beneficial for pain relief across species 5.

Evidence Quality and Controversies

The most recent guidelines from the American Heart Association and American Red Cross (via Praxis Medical Insights, 2025) provide the strongest recommendations 1. However, there remains some controversy in the literature regarding optimal treatments, particularly for different jellyfish species 6, 4, 5.

The 2010 AHA guidelines specifically recommend hot water immersion for pain relief, which is supported by more recent evidence 2, 1. The effectiveness of lidocaine has gained support in recent research, showing it both relieves pain and may prevent further nematocyst discharge 3.

While vinegar is widely recommended for initial decontamination, its effectiveness may vary by species, highlighting the importance of regional treatment protocols 6, 5.