Popularly promoted remedies range from vinegar to meat tenderiser to baking soda mixed with water. In a pinch, the victim - or a very good friend - might try urinating on the sting.
"Current research demonstrates variable response to treatment, often with conflicting results according to species studied, which contributes to considerable confusion about what treatment is warranted," wrote Nicholas Ward, at the University of California, San Diego, in the Annals of Emergency Medicine.
Though the American Heart Association and American Red Cross currently recommend using vinegar or a baking soda "slurry", followed by heat or ice, those remedies are based mainly on studies done in Australia and Indonesia, he added in an e-mail.
The jellyfish species there aren't commonly found in North American waters, so Ward said he and his colleagues studied medical literature for studies specific to North American and Hawaiian jellyfish, and found 19.
Based on those studies, it seems the most broadly effective remedies are simple hot water and creams containing the pain-numbing medication lidocaine.
Vinegar
"The principle behind the use of lidocaine is that it acts as a local anaesthetic [and] appears to inhibit the further discharge of nematocysts remaining on the skin," Ward said.
Nematocysts are the "venom sacs" jellyfish leave behind as a further insult after they sting. It's important to get those off the skin, because they can continue to release venom.
Simple hot water might help by "denaturing" and inactivating the venom, Ward said. But hot water might not be available at the beach, and not everybody carries lidocaine with them.
In that case, removing the venom sacs from the skin and washing the area with saltwater might help, though the sacs must be handled with care. The edge of a credit card, or something similar, might work well.
"The idea is to avoid crushing the sac and spreading venom, which wiping off with a towel could do," he said.
Vinegar does help with some species, such as bluebottles or Portuguese man-of-wars, which are mainly found off the coast of Florida and in the Gulf of Mexico.
But vinegar may actually worsen the pain of stings from most North American jellyfish, as well as causing any remaining venom sacs to discharge, Ward said.
"Hot water and lidocaine appear more widely beneficial," he wrote.
- Reuters
SAWDIS: I recommend the use of hot water if you get stung by jellyfish or bluebottles. I recently got stung by bluebottles while swimming at Santos Beach in Mossel Bay. They really got hold of me in a bad way and I decided to leave for home immediately after I managed to scrape off the tentacles with sea sand. I took a long (20 minute) hot shower until the pain eased. It really worked for me. I would however not recommend vinegar or meat tenderizer. Rather use hot water to relief the pain. Just a word of warning. Some people are allergic to the venom of these sea creatures. If you experience fever, shock, and interference with heart and lung function seek medical attention. Stings may also cause death, although this is extremely rare. If pain persists or is intense, there is an extreme reaction, the rash worsens, a feeling of overall illness develops, a red streak develops between swollen lymph nodes and the sting, or either area becomes red, warm and tender get to your nearest hospital as soon as possible.
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