Heat reduces pain in the majority of injuries by penetrating spines as well as non-tropical jellyfish stings. It does not destroy any venom already injected.
- Ask the person to rest while providing reassurance.
- Gain consent to provide (and document) treatment.
- Manage any signs the venomous creature:
- non-tropical jellyfish—pick off any tentacles with gloved fingertips and rinse the sting area well with seawater to remove invisible nematocysts (stinging capsules)
- stingray barb—control any bleeding
- protruding sea urchin spine—remove the spine with tweezers.
- Turn on a hot water shower or tap and make the temperature as hot as the person can comfortably tolerate.
- Place the person’s stung area in the hot water for 20 minutes and ask the person to rate their pain level from ‘no pain’ (0) to ‘worst pain possible’ (10).
- Reassess the person’s level of pain by asking them to rate it again.
- Send for help if heat fails to relieve the person’s pain, or if unable to manage other symptoms.
Note
- Do NOT remove any embedded objects, e.g., stingray barbs, sea urchin spines or stonefish spines. These need to be removed by a medical practitioner in a hospital setting to reduce further injury and prevent infection.
- Do NOT allow rubbing of the stung area.
- If local pain is unrelieved by heat, or if hot water is not available, apply a wrapped cold pack or ice.
- If possible, top up with more hot water as necessary, testing the temperature each time.
- Send for help and request an ambulance if:
- pain persists or is generalised (felt over a wide area)
- the sting area is large (half of a limb or more)
- the sting involves sensitive areas, e.g., the eye.