It’s straightforward to be confused about learn how to deal with a jellyfish sting. Is it greatest to make use of grandfather’s slurry of bicarbonate of soda or a douse of vinegar? Is it greatest to make use of an ice pack, take a scorching bathe or ask somebody to urinate in your leg?
Even consultants disagree about the appropriate first support. And pointers about learn how to deal with the stings can appear complicated due to several types of jellyfish in several components of Australia.
As an example, first support differs between temperate and tropical waters (north and south of Bundaberg in Queensland), as highlighted earlier this week.
However we don’t solely want to contemplate the kind of jellyfish and the place in Australia persons are stung. We additionally want to contemplate if a remedy works (is efficient), is secure and finally whether or not it’s sensible.
Scorching water (however not too scorching) for bluebottle stings
Treating bluebottle (Physalia) stings is an effective instance of the steadiness of effectiveness, security and practicality.
Bluebottle stings happen all through Australia, extra generally on uncovered seashores after onshore winds. They’re liable for 1000’s of stings every year within the hotter months. They trigger fast intense native ache lasting for an hour, or extra in extreme circumstances. On the sting website there’s a attribute raised purple line that is still for hours to days.
There may be good proof immersing somebody in scorching water works when treating bluebottle stings. Scorching water inactivates the jellyfish toxins and so stops the ache; it’s efficient in about 90% of circumstances after 20 minutes.
However there’s much less proof scorching water remedy is secure as there’s a danger that if the water is hotter than 46°C it could burn. It may also not be sensible to immerse somebody in scorching water on a seashore.
So what occurs in the actual world? Surf life-savers may put victims in a scorching bathe. It is because the danger of a burn is low (in the event that they take a look at the water first), it’s sensible and nonetheless prone to be efficient.
In case your youngster is stung and you might be near residence, head residence, run a scorching bathtub (take a look at your youngster can tolerate the temperature) and get your youngster to soak for about 20 minutes.
Recommendation modifications as we head north
Issues grow to be extra complicated as you go north. Right here, seashore goers face main field jellyfish (Chironex fleckeri) stings, which could be life-threatening, and Irukandji syndrome, which might trigger such extreme ache it’s essential to be handled in hospital.
For these, is it greatest to make use of vinegar or scorching water? Once more it’s primarily a query of security.
A research printed earlier this week discovered that for treating field jellyfish, immersion in scorching water is not any simpler than utilizing an ice pack.
So, whereas now we have seen scorching water is greatest for bluebottle stings, it doesn’t appear to work so properly for field jellyfish in northern waters. This may occasionally merely be as a result of delay in software of scorching water within the emergency division with field jellyfish in comparison with remedy on the seashore for bluebottle stings. Or it might be a species distinction.
So how ought to we interpret this? At present the suggestions in hospitals are to make use of ice packs to alleviate the ache of field jellyfish stings. This appears to be as efficient as immersing in scorching water within the current research, and positively simpler to do and safer. So, we should always proceed to make use of ice packs within the emergency division.
What about for main field jellyfish stings on the seashore in Darwin, or Far North Queensland? That is harder to reply.
In animal research scorching water inactivates its venom. So it’s seemingly that scorching water can be efficient if administered early. So, on the face of it, it may be cheap to place folks in a scorching bathe.
However, if you’re stung by a field jellyfish in tropical waters, the preliminary precedence is to not deal with the ache however to stop extreme envenomation, a course of that’s not clearly understood however can result in cardiac arrest and loss of life.
So, the present advice is to make use of vinegar, which we’ll come again to, and a direct switch to hospital. If the particular person stops respiratory or has a cardiac arrest, they want fast, fundamental life help.
Vinegar for tropical field jellyfish, for now
This brings us to the query of whether or not to make use of vinegar to deal with field jellyfish in tropical waters.
Vinegar has been really useful for many years to deal with field jellyfish stings primarily based on a single research. The concept is vinegar prevents the additional firing of stinging cells. However there’s little proof to recommend making use of vinegar has improved victims’ well being or chance of dying from a sting.
Then, there’s conflicting proof about whether or not vinegar is dangerous. A laboratory research discovered vinegar may very well improve the discharge of venom.
Clearly we want additional proof to see if vinegar is efficient and dangerous in a real-life state of affairs.
However with no real-world proof of hurt in treating field jellyfish stings, and the potential advantages in stopping life-threatening envenoming, it ought to stay the preliminary first support for these stings.
We simply assume if the venom is inactivated it should lower the severity of the sting.
Jury’s out on vinegar for Irukandji syndrome
Subsequent comes first support for Irukandji syndrome, brought on by being stung by a variety of jellyfish together with Carukia barnesii. These jellyfish are discovered primarily in tropical waters within the north. Though some species happen in southern waters, these not often sting.
Treating Irukandji syndrome is harder as a result of normally folks don’t recognise they’ve been stung till about 30 minutes later. The ache is extreme and generalised (chest, again and stomach), needing remedy with robust opioid painkillers. A small proportion of individuals could develop coronary heart issues.
Utilizing vinegar to deal with Irukandji syndrome is once more controversial. The proof could weigh extra towards it inflicting hurt, with little proof of profit. There is no such thing as a proof for utilizing scorching water.
No proof for urine or bicarbonate of soda
Then there’s the outdated fable of utilizing urine to deal with jellyfish stings, popularised within the TV collection Associates.
There’s no proof to again that, or for utilizing a slurry of bicarbonate of soda.
The place to subsequent?
Present pointers may seem complicated, however are primarily based on one of the best out there proof. In some circumstances this proof is a randomised-controlled trial, the place victims are chosen at random to obtain a remedy and in contrast with others who obtain one other remedy (or no remedy). However in different circumstances, pointers are primarily based on anecdote and knowledgeable opinion, which require difficult.
We additionally want extra analysis, for example on the effectiveness and security of vinegar, each for Chironex fleckeri stings and Irukandji syndrome.