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  • Jellyfish Stings

    Many forms of marine life (such as jellyfish, stingrays, sea urchins, stinging coral and spiny fish) cause stinging wounds. Stings from marine life can have effects that range from merely painful to very serious (such as allergic reactions that can cause breathing and heart problems, paralysis or even death).

    Signs and Symptoms of Jellyfish Stings

    Signs and symptoms of marine life stings include pain and swelling at the site. You may also see a puncture wound or laceration. If the person is allergic to marine life stings, the person will show signs and symptoms of an allergic reaction or anaphylaxis.

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    Emergency Steps

    1

    Check scene safety, form an initial impression, obtain consent and put on PPE, as appropriate.

    2

    Check for signs and symptoms.

    • Signs & symptoms of a severe allergic reaction/anaphylaxis (if allergic to insect stings)*
    • Signs & symptoms of shock*
    • Sting by known lethal jellyfish*
    • Sting by unknown marine life*
    • History of allergy to marine life sting*
    • Sting to the neck or face*
    • Pain or swelling at the site
    • Puncture wound or laceration

    *Note: Signs and symptoms with an * require immediate emergency medical treatment.

    3

    Call 9-1-1 and get equipment if the person requires immediate emergency medical treatment.

    4

    Give Care.

    General Care

    1. Get the person out of the water as soon as possible.
    2. Carefully remove tentacles with a gloved hand, hand wrapped in a plastic bag or a towel, blunt stick or plastic utensil.
      1. If these items are not available, use seawater to flush the area.
    3. Immerse affected area in water as hot as tolerated for at least 20 minutes or until pain is relieved.
      1. Water should be hot without scalding them.
    4. If hot water is not available, use a chemical heat pack or another hot item (e.g., hot rock or sand).
      1. Wrap object in a thin, dry towel to protect the skin.
    5. If heat sources not available, or after applying heat, apply lidocaine gel, if available.
    6. Do not rub the area or apply an elastic bandage.
    7. Watch for changes in condition, including breathing and responsiveness and signs of shock, and give care as appropriate and trained.

    Jellyfish Stings FAQs

    When would a marine life sting be considered a life-threatening situation?

    A life-threatening situation would include the following:

    • Lethal jellyfish sting
    • Lack of knowledge about what stung the person
    • History of allergic reactions to marine life stings
    • Sting on the face or neck
    • Signs & symptoms of shock or anaphylaxis, including trouble breathing.

    What if a person does not know what stung them?

    Call 9-1-1 if a person does not know what stung them. The stings of some forms of marine life can make a person seriously ill and be life-threatening.

    What should be done if a person is stung by a sea urchin, stingray or spiny fish?

    If the bite is from a sea urchin, stingray or spiny fish:

    • Flush the wound with tap water or ocean water.
    • Keep the injured part still.
    • Soak it in water as hot as the person can tolerate it for at least 20 minutes, or until the pain goes away.
    • Have the person follow up with a healthcare provider about the need for tetanus shot and monitor the wound for signs and symptoms of infection.

    How to Give Medication

    1. Trained
      1. Have them sit in a comfortable position or lie down if showing signs of shock.
      2. Verify the medication with them.
      3. Remove the cap and safety device on the auto-injector.
      4. Locate the outside middle of one thigh to use as the injection site.
      5. Hold their leg firmly.
      6. Administer the medication at a 90-degree angle.
        1. Hold it in place for 3 seconds after a click is heard.
      7. Massage the injection area for 10 seconds.
      8. Note the time of administration and any changes in condition.
      9. If they have signs and symptoms 5 to 10 minutes after the first dose and EMS has not arrived, administer a second dose.
      10. Give the auto-injector to EMS on arrival.
    1. Untrained
      1. Have them sit in a comfortable position or lie down if showing signs of shock.
      2. Give them the epinephrine auto-injector.
      3. Hold their leg firmly to limit movement.
      4. Encourage use of the auto-injector as prescribed.
        1. Make sure they hold the auto-injector firmly in place for 3 seconds after a click is heard.
      5. Massage or have them massage the injection area for 10 seconds.
      6. Note time of administration and any changes in condition.
      7. If they have signs and symptoms 5 to 10 minutes after the first dose and EMS has not arrived, help them administer a second dose.
      8. Give the auto-injector to EMS on arrival.

    Treating Sea Urchin, Stingray, or Spiny Fish Stings

    What should be done if a person is stung by a sea urchin, stingray, or spiny fish?

    If the bite is from a sea urchin, stingray or spiny fish:

    1. Flush the wound with tap water or ocean water.
    2. Keep the injured part still.
    3. Soak it in water as hot as the person can tolerate it for at least 20 minutes, or until the pain goes away.
    4. Have the person follow up with a healthcare provider about the need for tetanus shot and monitor the wound for signs and symptoms of infection.

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    Information Provided the Scientific Advisory Council (SAC)

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