First aid: Best ways to treat stinging injuries

Updated: 15 Mar, 2021

I really hate jellyfish, (though they’re called sea jellies now).

Not as much as mosquitoes, but close.

From what I’ve been taught & read – salt water first to wash of tentacles. Then vinegar/Coke/acid to kill any lingering active stinging cells, and then/or hot water.

Here’s from Divers Alert Network (DAN):

What is the basic first aid for jellyfish stings?

Divers who have encountered jellyfish usually complain of a stinging or burning sensation. Do not let the affected diver rub or scratch the sting (this worsens and spreads it). The stung diver may develop hives and have an allergic reaction with laryngeal (throat) swelling that may lead to airway blockage, respiratory distress, cardiac irregularities, and loss of consciousness. Basic treatments include:
Immediately flood the wound with vinegar (5% acetic acid). Keep the victim as still as possible. Continuously apply the vinegar until the victim can be brought to medical attention. If you are out at sea or on an isolated beach, allow the vinegar to soak the tentacles or stung skin for 10 minutes before attempting to remove adherent tentacles or to further treat the wound. In Australia, surf lifesavers (lifeguards) may carry antivenin, which is given as an intramuscular injection – a first aid measure.
Flush the area with large amounts of sea water to remove any remaining tentacles.
Immerse the affected area in hot water for 30 to 90 minutes to reduce and / or manage pain.
Remove any remaining tentacle pieces with forceps/tweezers.
Shave the area using shaving cream and a safety razor.
Apply hydrocortisone cream or lotion.
Monitor for allergic reaction or infection.
Apply warm(45C/113F max) packs to control the pain. This may be repeated as necessary.
If the victim has a large area involved (entire arm or leg, face, or genitals), is very young or very old, or shows signs of generalized illness (nausea, vomiting, weakness, shortness of breath or chest pain), seek help from a doctor. If a person has placed tentacle fragments in his mouth, have him swish and spit whatever potable liquid is available. If there is already swelling in the mouth (muffled voice, difficulty swallowing, enlarged tongue and lips), do not give anything by mouth, protect the airway and rapidly transport the victim to a hospital.

Source: https://www.dansa.org/blog/2016/03/04/jellyfish-stings

The “5% acetic acid” can be the tricky bit.

We use vinegar because it’s acidic. Anything acidic will work to kill/breakdown the toxin.
Coca-Cola, for example, works well, but tends to be sticky and more expensive.

What’s pH?

It’s a scale to describe how acidic or basic something is, which kind of means, “does it have excess hydrogen (H+), or excess hydroxide (OH−)?”

It’s a scale from 0 (acidic) to roughly 14 (basic, or alkaline). 7 is neutral.

Peeing on Friends for Fun

Anything that’s acidic ENOUGH will work.

Urine is not acidic enough. It’s barely acidic at all. Urine is around 6.5-7 in the morning.
In fact, by the evening, urine is alkaline (7.5-8.0) – the opposite of acidic!

So please, don’t pee on your friends, unless it’s unrelated to jellyfish stings and you’re both consenting adults.

Ph Levels

If you’re needing to improvise, here’s a list of some common drinks and their acidity. Lower is better (more acidic).

Vinegar is about 2.4.
Coke (normal) or Cherry Coke is about 2.5.
Fanta Orange is about 2.8
Pepsi is about 2.9
Diet Pepsi is about 3.0
Coke Zero is about 3.2
Diet Coke is about 3.3
Red Bull is about 3.4
Orange juice is about 3.8
Budweiser beer and Listerine are about 4.3

Numbers have been rounded up, generally speaking, to be more conservative.

[Source: https://www.sheltondentistry.com/patient-information/ph-values-common-drinks ]

Pro Tip

Keep a small spray bottle with vinegar in your dry bag or on the boat. When you just have a normal bottle, and splash it over the affected area, you waste a lot of it. If you spray a fine mist, you can help alleviate the symptoms more quickly, effectively and efficiently with a mist-spray. This is especially important if multiple people have been stung, as sometimes happens when waiting on the surface to be picked up by your dive boat.

I use a small plastic pump spray bottle – the kind used for cheap perfumes. It’s portable and 30ml lasts for a very long time.

If you don’t have a spray bottle, use some tissue or paper towel, and soak it in the vinegar, then place over the affected area. It will help keep more of the acid on the stung area, for longer.

Post Sting Treatment

Okay, you’ve been stung, didn’t think it was too bad, or didn’t have access to vinegar, coke or a friend with weak bladder control (again, don’t pee on people for sting treatment.) It’s started to burn more, and get worse.

What should you do?

Call DAN (Divers Alert Network) for advice. They can recommend doctors and treatments. The people you talk to are often not trained medical professionals, but they can get you in touch with someone who is.

World: +61-8-8212-9242
Australia: 1800-088-200
Americas: +61-8-8212-9242
Europe: +39-06-4211-8685
Japan: +81-3-3812-4999
Southern Africa: 0800-020-111
+27-10-209-8112
DES (not DAN) New Zealand: 0800-4DES-111
Korean Hotline (not DAN): 055-549-0912

Go to a doctor.
Go to a pharmacist. Which brings me to the next subject:

Drugs

There are a few drugs you can take to help alleviate symptoms. First: See a doctor or pharmacist for advice. I am NOT a medical professional.

Topical antihistamine cream

This is for rashes and such due to an allergy / reaction and commonly used for reactions from plants like poison ivy, poison oak, or poison sumac.

An antihistamine or calamine lotion – or combination of them in a single product can work great.

This is my go-to treatment. Apply 3 times a day.

Topical steroid cream

Primarily for inflammation and swellings. Be aware that there are serious issues with long-term use of this, including a thinning of the skin.

Oral antihistamine tablets

This can be great to help you sleep; they reduce the itchiness of the stings and cause drowsiness. Be aware that the lethargy can continue into the next day! Plan your dosage and diving carefully!

Lastly, how to not get stung in the first place

In short: cover up.

Long (full) wetsuits. Stinger suits (full body rashguards). Rashguard plus yoga pants. Anything to make sure no skin is uncovered. A cap to cover your ears is handy, but a coif (a cap which continues around your neck and over your shoulders) is better still.

The materials do not need to be thick! In warm tropical water, wearing a thick wetsuit and everything else can cause hyperthermia (overheating). Thin is fine. Even just pantyhose will be sufficient to protect your legs from most stings!

Use a special cold-water regulator mouthpiece to help protect your lips… or just go with a full face mask (make sure you get trained and prepared for it though!)