- Jellyfish inject venom on contact with skin, through microscopic nematocyst tubules located on the tentacles or bulb of the animal.
- Nematocysts from different species of jellyfish are inhibited by different substances used for first-aid, those being hot water and vinegar.
Tropical Jellyfish
Tropical waters range approximately from Geraldton and extends north around the coast line of Western Australia.
- Box jellyfish
- Inhabit estuarine and on shore coastal tropical waters.
- Can cause respiratory and cardiac arrest within minutes in large stings.
- Jellyfish producing Irukandji syndrome
- Sting can be minor, followed in 5-40 minutes time by severe generalised pain and cramping, nausea and vomiting, difficulty breathing, sweating, anxiety and feeling of impending doom.
- Heart failure, severe hypertension, pulmonary oedema and hypertensive stroke.
Non-tropical Jellyfish
- In other regions of Australia, the objective of treatment is pain relief.
Venomous Fish
- Venom is deposited through spines causing excruciating pain. Cardiovascular toxic effects can occur, but are rare.
- Pain, from mild irritation to intense, sharp or burning.
- Muscle aches and cramps, moderate to severe.
- Nausea, vomiting, headache.
- Whips and wheel marks, may be visible or absent varying by species.
- Raised welts.
- Sweating at the site.
- Restlessness, anxiety and irrational behavior.
- In Irukandji: severe hypertension, sense of impending doom, development of pulmonary oedema.
- Difficulty breathing.
- Collapse, followed by respiratory or cardiac arrest.
- Children are at increased risk of envenomation due to small body size.
- Vinegar will deactivate non-discharged nematocysts, but not reduce the pain of venom already injected.
- Antivenom is available for some Box Jellyfish species.
- Patients initially stable but suffering severe symptoms within 30 minutes may have an Irukandji sting and require immediate medical attention.
- Contact the CSP in SOC if further information or advice is needed.
- Liberally douse/spray area with vinegar for 30 seconds to neutralize visible stinging cells
- If no vinegar is available: remove tentacles with gloved hands and wash well with sea water, NOT fresh water
- Antivenom is available for some box jellyfish
- Transport URGENTLY
- Remove any visible tentacles and rinse well with sea water, NOT fresh water
- Where possible, place the stung area in water as hot as the patient can comfortably tolerate for 20 minutes
- If pain not relieved by heat or hot water unavailable, apply cold pack
- Treat for haemorrhage or impaled object if required
- If stung on a limb, immerse stung area in water as hot as the patient can comfortably tolerate
- Primary Survey
- Keep patient at rest and limit movement where possible
- Assist ventilations as required
- Manage cardiac arrest as per guidelines
- Observe patient closely for signs of anaphylaxis; if identified, treat accordingly.
- Refer to treatment for TROPICAL/NON-TROPICAL Jellyfish sting OR VENOMOUS FISH in the above table
- Use cold compress to reduce pain and swelling at the site if specific treatment cannot be carried out
- Conduct Vital Sign Survey
- Consider pain relief
- Consider anti-emetic
- Consider applying cardiac monitor if trained and authorised
- Monitor patient persistently, recording full observations every 10 minutes (or 5 minutes if time critical)
- Transport Priority 1 if patient time critical, pre-notifying receiving facility
- Apply cardiac monitoring
- Consider vascular access; obtain pre-hospital blood sample
- Consider pain relief
- Consider anti-emetic
- Monitor patient persistently, recording full observations every 10 minutes (or 5 minutes if time critical)
- Transport Priority 1 if patient time critical, pre-notifying receiving facility
- As per Advanced Care guidelines
Additional Information
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