From the Guidelines
For jellyfish stings in the field, immediately remove any remaining tentacles by lifting or pulling while avoiding manual contact, and then rinse the affected area with seawater to remove the tentacle, as recommended by the 2024 American Heart Association and American Red Cross guidelines for first aid 1. The most recent and highest quality study, published in 2024, provides the best evidence for the treatment of jellyfish stings in the field 1. Some key points to consider when treating jellyfish stings include:
- Removing any remaining tentacles by lifting or pulling while avoiding manual contact, as this can help prevent further envenomation 1.
- Rinsing the affected area with seawater to remove the tentacle, as this can help neutralize the venom and reduce pain 1.
- Using nonscalding hot water immersion or irrigation, or applying a heat source to relieve pain, as this can help denature the venom proteins and reduce discomfort 1.
- Considering the use of topical lidocaine cream or gel for pain control if hot water is not available, as this can help inhibit nematocyst discharge or decrease pain from stings 1. It's also important to observe the person with a jellyfish sting for systemic reaction and call emergency services for difficulty breathing, signs of shock, or severe pain, as recommended by the guidelines 1. Additionally, a study published in the same year provides supportive text for the recommendations, highlighting the importance of proper removal of tentacles and rinsing with seawater, as well as the benefits of hot water immersion or irrigation for pain relief 1.
From the FDA Drug Label
1 INDICATIONS & USAGE Adrenalin® is available as a single-use 1 mL vial and a multiple-use 30 mL vial for intramuscular and subcutaneous use. Emergency treatment of allergic reactions (Type I), including anaphylaxis, which may result from allergic reactions to insect stings, biting insects, foods, drugs, sera, diagnostic testing substances and other allergens, as well as idiopathic anaphylaxis or exercise-induced anaphylaxis.
The treatment for a jellyfish sting in the field is not directly addressed by the epinephrine (IM) drug label.
- Key points:
- The label mentions emergency treatment of allergic reactions, including anaphylaxis.
- It does not specifically mention jellyfish stings. Therefore, based on the provided information, epinephrine (IM) may be considered in cases of anaphylaxis, but its use for a jellyfish sting is not directly supported by the label 2.
From the Research
Treatment for Jellyfish Stings
- The treatment of jellyfish envenomation is directed at alleviating the local effects of venom, preventing further nematocyst discharges, and controlling systemic reactions, including shock 3.
- Effective painkillers for jellyfish stings include oral/topical analgesics, hot water, and ice packs 3.
- A 30-second application of domestic vinegar (4%-6% acetic acid) can prevent further discharge of unfired nematocysts remaining on the skin, but its use is not universally recommended and may depend on the species of jellyfish 3, 4.
- Submersion in hot water has been shown to be superior to ice packs in achieving clinically significant pain relief 5.
- Treatment with vinegar or other substances compared to hot water may make the skin appear worse 5.
First Aid and Prevention
- Removing nematocysts and washing the area with saltwater may be considered if hot water and topical lidocaine are not available 4.
- Wearing a full-body stinger suit or applying a sting-inhibiting lotion can reduce the risk of jellyfish injuries 6.
- Avoiding waters during jellyfish season is recommended in regions that harbor more dangerous species of jellyfish 6.
- Adequate signage should be placed at beaches to notify tourists of the jellyfish risk, and swimmers in risky areas should wear protective equipment 3.