title: A randomized paired comparison trial of cutaneous treatments for acute jellyfish (Carybdea alata) stings.
abstract: The objective of the study was to compare cutaneous treatments (heat, papain and vinegar) for acute jellyfish (Carybdea alata) stings. Healthy adult volunteer subjects received a single-tentacle jellyfish sting on each forearm. One forearm was treated with hot-water immersion (40-41 degrees C). This was compared with the other forearm, which was randomized to a comparison treatment of papain meat tenderizer or vinegar. Pain was measured at 0, 2, 4, 6, 8, 10, 15, and 20 minutes using a 10-cm visual analog scale (VAS). For 25 subject runs, the average VAS scores at t = 0 were 3.6 cm (hot water) and 3.7 cm (comparison treatment). At t = 4 minutes (2 minutes after treatment had started), the differences between hot-water and comparison group VAS scores were 2.1 cm versus 3.2 cm, respectively. The mean difference between hot-water and comparison treatments was 1.1 cm (95% confidence interval, 0.6 to 1.6). At t = 20 minutes (the end of the study period), the differences between hot-water and comparison group VAS scores were 0.2 cm versus 1.8 cm, respectively. The mean difference between hot-water and comparison treatments was 1.6 cm (95% confidence interval, 0.9 to 2.3). This study suggests that the most efficacious initial treatment for C alata jellyfish envenomation is hot-water immersion to the afflicted site.
authors.affiliation: Emergency Department, Kapiolani Medical Center For Women And Children, University of Hawaii John A. Burns School of Medicine, Honolulu, HI, USA.
authors.forename: Jason T
authors.initials: JT
authors.lastname: Nomura
authors.forename: Renee L
authors.initials: RL
authors.lastname: Sato
authors.forename: Reina M
authors.initials: RM
authors.lastname: Ahern
authors.forename: Joanne L
authors.initials: JL
authors.lastname: Snow
authors.forename: Todd T
authors.initials: TT
authors.lastname: Kuwaye
authors.forename: Loren G
authors.initials: LG
authors.lastname: Yamamoto
mesh_terms: D019342:Acetic Acid / Q000008:administration & dosage; D000279:Administration, Cutaneous; D000328:Adult; D001733:Bites and Stings / Q000628:therapy*; D037462:Cubozoa; D004638:Emergency Treatment / Q000379:methods*; D005260:Female; D005542:Forearm; D006358:Hot Temperature; D006801:Humans; D007101:Immersion; D008297:Male; D010146:Pain / Q000473:pathology / Q000517:prevention & control*; D010147:Pain Measurement; D010206:Papain / Q000008:administration & dosage; D016037:Single-Blind Method; D016896:Treatment Outcome
chemical_list: D010206:Papain; D019342:Acetic Acid