First aid: Stinging injuries

Updated: 14 Nov, 2018

I really hate jellyfish, (though they’re called sea jellies now).

Not as much as mosquitoes, but close.

From what I’ve been taught & read – salt water first to wash of tentacles. Then vinegar/Coke/acid to kill any lingering active stinging cells, and then/or hot water.

Here’s from the PADI rescue presentation notes:

What is the basic first aid for jellyfish stings?

Divers who have encountered jellyfish usually complain of a stinging or burning sensation. Do not let the affected diver rub or scratch the sting (this worsens and spreads it). The stung diver may develop hives and have an allergic reaction with laryngeal swelling that may lead to airway blockage, respiratory distress, cardiac irregularities, and loss of consciousness. Basic treatments include:

  1. Rinsing the affected area with generous amounts of sterile saline solution or seawater (not fresh).
  2. To deactivate any remaining nematocysts, the injured area is soaked with 5 percent acetic acid until the pain is relieved.
  3. If acetic acid is not available, household ammonia diluted three parts water to one part ammonia can be used.
  4. If possible apply shaving cream to the affected area and shave it clean. Resoak the affected area with the acetic or ammonia solution.
  5. Hot packs (if available) are applied to the injured area because the heat will break down the injected toxin.

“Soaked in 5% acetic acid” is the tricky bit.

We use vinegar because it’s acidic. Anything acidic will work to kill/breakdown the toxin.
Coca-Cola, for example, works well, but tends to be sticky and more expensive.

What’s pH?

It’s a scale to descibe how acidic or basic something is, which kind of means, “does it have excess hydrogen (H+), or excess hydroxide (OH−)?”

It’s a scale from 0 to roughly 14 (generally speaking). 7 is neutral.

Peeing on Friends for Fun

Anything that’s acidic ENOUGH will work.

Urine is not acidic enough. It’s barely acidic at all. Urine is around 6.5-7 in the morning.
In fact, by the evening, urine is alkaline (7.5-8.0).

So please, don’t pee on your friends, unless it’s unrelated to jellyfish stings and you’re both consenting adults.

Ph Levels

If you’re needing to improvise, here’s a list of some common drinks and their acidity. Lower is better (more acidic).

Vinegar is about 2.4.
Coke (normal) or Cherry Coke is about 2.5.
Fanta Orange is about 2.8
Pepsi is about 2.9
Diet Pepsi is about 3.0
Coke Zero is about 3.2
Diet Coke is about 3.3
Red Bull is about 3.4
Orange juice is about 3.8
Budweiser beer and Listerine are about 4.3

Numbers have been rounded up, generally speaking, to be more conservative.

[Source: https://www.sheltondentistry.com/patient-information/ph-values-common-drinks ]

Pro Tip

Keep a small spray bottle with vinegar in your dry bag or on the boat. When you just have a normal bottle, and splash it over the affected area, you waste a lot of it. If you spray a fine mist, you can help alleviate the symptoms more quickly, effectively and efficiently with a mist-spray. This is especially important if multiple people have been stung, as sometimes happens when waiting on the surface to be picked up by your dive boat.

I use a small plastic pump spray bottle – the kind used for cheap perfumes. It’s portable and 30ml lasts for a very long time.

If you don’t have a spray bottle, use some tissue or paper towel, and soak it in the vinegar, then place over the affected area. It will help keep more of the acid on the stung area, for longer.

Post Sting Treatment

Okay, you’ve been stung, didn’t think it was too bad, or didn’t have access to vinegar, coke or a friend with weak bladder control (again, don’t pee on people for sting treatment.) It’s started to burn more, and get worse.

What should you do?

  • Call DAN (Divers Alert Network) for advice. They can recommend doctors and treatments. The people you talk to are often not trained medical professionals, but they can get you in touch with someone who is.
  • Go to a doctor.
  • Go to a pharmacist. Which brings me to the next subject:

Drugs

There are a few drugs you can take to help alleviate symptoms. First: See a doctor or pharmacist for advice. I am NOT a medical professional.

Topical antihistamine cream

This is for rashes and such due to an allergy / reaction and commonly used for reactions from plants like poison ivy, poison oak, or poison sumac.

This is my go-to treatment. Apply 3 times a day.

Topical steroid cream

Primarily for inflammation and swellings. Be aware that there are serious issues with long-term use of this, including a thinning of the skin.

Oral antihistamine tablets

This can be great to help you sleep; they reduce the itchiness of the stings and cause drowsiness. Be aware that the lethargy can continue into the next day! Plan your dosage and diving carefully!

Further reading

What are Topical antihistamines? – Drugs.com: Topical Antihistamines
“What Is the Best Cream for Itchy Skin (Pruritus)?” – Verywellhealth

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