title: Heated Debates: Hot-Water Immersion or Ice Packs as First Aid for Cnidarian Envenomations?
abstract: Cnidarian envenomations are an important public health problem, responsible for more deaths than shark attacks annually. For this reason, optimization of first-aid care is essential. According to the published literature, cnidarian venoms and toxins are heat labile at temperatures safe for human application, which supports the use of hot-water immersion of the sting area(s). However, ice packs are often recommended and used by emergency personnel. After conducting a systematic review of the evidence for the use of heat or ice in the treatment of cnidarian envenomations, we conclude that the majority of studies to date support the use of hot-water immersion for pain relief and improved health outcomes.
authors.affiliation: Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A. Burns School of Medicine, University of Hawai'i at Mānoa, Honolulu, HI 96822, USA. wilcoxcl@hawaii.edu.
authors.forename: Christie L
authors.initials: CL
authors.lastname: Wilcox
authors.affiliation: Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A. Burns School of Medicine, University of Hawai'i at Mānoa, Honolulu, HI 96822, USA. ayanagih@hawaii.edu.|Békésy Laboratory of Neurobiology, Pacific Biosciences Research Center, School of Ocean and Earth Science and Technology, University of Hawai'i at Mānoa, Honolulu, HI 96822, USA. ayanagih@hawaii.edu.
authors.forename: Angel A
authors.initials: AA
authors.lastname: Yanagihara
mesh_terms: D000818:Animals; D001733:Bites and Stings / Q000628:therapy*; D003063:Cnidaria; D003064:Cnidarian Venoms / Q000633:toxicity*; D017679:Cryotherapy; D006358:Hot Temperature / Q000627:therapeutic use*; D006801:Humans; D016032:Randomized Controlled Trials as Topic
chemical_list: D003064:Cnidarian Venoms
keywords: Cubozoa; Hydrozoa; Scyphozoa; first aid; hot-water immersion; ice packs; jellyfish; sting; venom