Evidence-based treatment of jellyfish stings in North America and Hawaii.
We performed a systematic review of the evidence supporting various treatments for envenomation by jellyfish (cnidarian) and related organisms in North America and Hawaii. Our review produced 19 pertinent primary articles. Current research demonstrates variable response to treatment, often with conflicting results according to species studied, which contributes to considerable confusion about what treatment is warranted and efficacious. Our review suggests that vinegar causes pain exacerbation or nematocyst discharge in the majority of species. Hot water and topical lidocaine appear more widely beneficial in improving pain symptoms and are preferentially recommended. Unfortunately, they may be difficult to obtain at the site of envenomation, such as the beach or diving sites. In these instances, removing the nematocysts and washing the area with saltwater may be considered. If the envenomation is thought to be due to the bluebottle (Physalia), vinegar may be beneficial.
Department of Emergency Medicine, Division of Medical Toxicology, UCSD Medical Center, University of California, San Diego, San Diego, CA, USA. niward@ucsd.edu
Nicholas T
NT
Ward
Michael A
MA
Darracq
Christian
C
Tomaszewski
Richard F
RF
Clark
D000818:Animals; D001733:Bites and Stings / Q000628:therapy*; D003064:Cnidarian Venoms / Q000037:antagonists & inhibitors; D006254:Hawaii; D006801:Humans; D058894:Nematocyst; D009656:North America; D059408:Pain Management / Q000379:methods; D037401:Scyphozoa; D037441:Sea Nettle, East Coast
D003064:Cnidarian Venoms