Jellyfish Sting

• Sting from a jellyfish
• Jellyfish cause most of the stings that occur in sea water
• The creature's stinger injects venom into the human skin. This is what causes the sting.
• The main symptoms are pain, burning and redness at the sting site. Red lines are common.
• The Sea Nettle is a type of stinging jellyfish often found in Chesapeake Bay

Jellyfish Facts

• They are umbrella shaped, clear sea creatures with long trailing tentacles. They move slowly through the water by pulsing the upper body. Also carried by ocean currents. Their tentacles can be 10 feet or longer.
• Other Names. Jellies or sea jellies. Large groups of jellies are called a bloom. Blooms can close beaches.
• Where They Live. Found in every ocean and coastline.
• Numbers. Jellies have increased in numbers worldwide. Warmer ocean temps and pollution of ocean waters are factors. Fishing the ocean too much is also a cause. Tuna, shark and swordfish eat jellies.
• Stings. Stings can occur while wading, swimming or diving in salt water. Honolulu gets over 1000 911 calls per month for stings.
• Beached Jellies. Even beached or dying jellies can sting. So can pieces of tentacles floating in the water. They can release venom for up to 2 weeks.
• Treatment. Vinegar is used to stop the venom in stingers. Caution: Do not use ammonia, urine, rubbing alcohol, fresh water or ice. They all can trigger the release of more venom. If you don't have vinegar, move on to scraping off the stingers.
• Prevention. Mainly do not go in the water where jellies are seen. Wearing a thin layer of clothing (such as pantyhose) also can protect you. Reason: The stingers are short and cannot puncture clothing. Special "stinger suits" can be bought in diving stores.

Cause of Sting Reactions

• The long tentacles have thousands of stingers.
• When a stinger is touched, it pierces the skin and injects venom.
• The venom is what causes all the symptoms.

Types of Jellyfish Sting Reactions

• Local Reactions are most common. Symptoms are raised, red lines that cross each other. The sting causes pain or burning at the site. Sometimes hives in the sting area occur. Blisters can occur in severe cases. Severe pain lasts 1-2 hours. Itch may last for a week. If the skin damage is severe, red or purple lines can last for weeks.
• General Reactions can occur if there are many stings. More stings give a higher dose of venom. Large venom symptoms are vomiting, dizziness, weakness and headache.
• Anaphylaxis (A severe allergic reaction). Life-threatening reactions are very rare with the stings. Most are caused by box jellyfish found in the South Pacific and Australia. The main symptoms are trouble breathing and swallowing, along with hives. It starts rapidly, most often within 20 minutes of the sting.

Call 911 Now

• Past severe allergic reaction to jellyfish stings (not just hives) and stung less than 2 hours ago
• Wheezing or trouble breathing
• Hoarseness, cough or tightness in the throat or chest
• Trouble swallowing or drooling
• Speech is slurred
• Acts or talks confused
• Passed out (fainted) or too weak to stand
• You think your child has a life-threatening emergency

Go to ER Now

• Hives or swelling all over the body (but normal breathing)
• Muscle cramps or spasms

Call Doctor or Seek Care Now

• Sting inside the mouth
• Sting on the eye
• Sting covers a large area (more than 1 arm or leg)
• Stomach pain or vomiting
• Fever and sting looks infected (spreading redness)
• Jellyfish sting and No past tetanus shots. Note: tetanus is the "T" in DTaP, TdaP, or Td vaccines.
• Severe pain not improved after 2 hours using care advice
• Your child looks or acts very sick
• You think your child needs to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

• Blisters appear
• More than 48 hours since the sting and redness getting larger
• Last tetanus shot was more than 10 years ago
• You think your child needs to be seen, but the problem is not urgent

Contact Doctor During Office Hours

• Severe itching not better after 24 hours of using steroid cream
• Redness or rash lasts more than 48 hours
• You have other questions or concerns

Self Care at Home

• Jellyfish sting - Normal local reaction

Care Advice for Jellyfish Sting

1. What You Should Know About Jellyfish Stings:
   • Jellyfish cause most of the stings that occur in the ocean.
   • Most stings are harmless. The pain is like a bee sting.
   • Jellies have long tentacles with lots of tiny stingers.
   • Pieces of tentacles that wash up on the beach can still cause stings.
   • They produce lines of redness and burning pain.
   • Here is some care advice that should help.
2. Step 1 - Sea Water Rinse to Remove Large Tentacles:
   • Rinse area with sea water. This will help remove any large tentacles stuck to the skin.
   • Do not rinse with fresh water (will trigger stingers).
   • Do not scrub or rub area (will trigger stingers).
   • Do this until you can get some vinegar.
3. Step 2 - Vinegar Rinse to Stop the Stinging: (Exception: Chesapeake Bay jellyfish - see #6)
   • Rinse area with vinegar (5% acetic acid) for 15 minutes.
   • Reason: Stops the stingers from stinging if still attached to the skin.
   • Caution: Do not use with Chesapeake Bay jellyfish. (Reason: May trigger stingers. Instead, use a baking soda rinse with these stings).
   • Avoid rubbing alcohol for all stings. Reason: will trigger the stingers.
   • If you can't get vinegar, move on to scraping off the stingers.
4. Step 3 - Scrape the Area to Remove Small Stingers:
   • Scrape off any stingers you can see. Use the edge of a credit card or dinner knife.
   • Do not use your bare fingers. (Reason: you will get stings on your hands). Put on gloves if you have them.
   • Then, coat area with shaving cream or any mild cream. Scrape the area again.
   • If the stingers are stuck to body hair, shave with a razor.
5. Step 4 - Repeat Vinegar Rinse: (Exception: Chesapeake Bay Jellyfish - go to #6)
   • Keep a cloth wet with vinegar on the area.
   • Do this for 15 more minutes.
6. Chesapeake Bay Jellyfish (Sea Nettle) - Baking Soda Rinse To Stop The Stinging:
   • Rinse area with a mixture of sea water and baking soda for 15 minutes.
   • This stops the stingers from stinging if still attached to the skin.
   • Then, remove small stingers with scraping or shaving.
   • Caution: Do not use vinegar rinse.
7. Pain Medicine:
   • To help with the pain, give an acetaminophen product (such as Tylenol).
   • Another choice is an ibuprofen product (such as Advil).
   • Use as needed.
8. Cold Pack for Pain:
   • For pain and swelling, rub with an ice cube. You can also use a cold wet washcloth. Do this for 10 minutes as needed.
   • Caution: Don't use until stingers are removed. (Reason: water or ice will trigger stingers).
9. Steroid Cream for Itching:
   • For itching or swelling, put 1% hydrocortisone cream (such as Cortaid) on the sting.
   • No prescription is needed.
   • Use 3 times per day.
   • Keep the cream in the fridge. (Reason: it feels better if put on cold).
10. What to Expect:
    • Minor stings: Severe burning pain will lessen within 1-2 hours. Red blotches and lines often improve in 24 hours. Red lines may last 1-2 weeks.
    • More severe stings: Blisters appear within 6 hours. You should be seen by a doctor if blisters appear.
11. Call Your Doctor If:
    • Blisters appear
    • Severe pain lasts over 2 hours
    • Redness or rash lasts over 2 weeks
    • You think your child needs to be seen
    • Your child becomes worse

Care Advice for Jellyfish Sting

This shows a jellyfish sting reaction. The sting will cause pain and swelling where the tentacles of the jellyfish touched the skin. The rash is red and swollen.