Don't Pee on that Jellyfish Sting!
Home remedies for jellyfish stings – such as vinegar, alcohol, meat tenderizer, baking soda and urine –may be less effective at relieving pain than plain hot water and lidocaine, according to a paper published online Tuesday in Annals of Emergency Medicine ("Evidence-Based Treatment of Jellyfish Stings in North America and Hawaii") annemergmed.com/webfiles/images/journals/ymem/ntward.pdf.
"Some of the remedies promoted by word of mouth and online, such as vinegar, actually make the pain worse with certain species of jellyfish," said lead study author Nicholas T. Ward, MD, of the University of California San Diego Department of Emergency Medicine. "Current evidence suggests hot water and topical lidocaine, which is available at local pharmacies, may be more universally beneficial in treating pain from a jellyfish sting. Topical lidocaine, a local anesthetic, may also inactivate the stinging cells of the jellyfish, preventing further envenomation."
Dr. Ward and his team performed a systematic review of 19 studies of various treatments for envenomation by jellyfish and related organisms in North America and Hawaii. Although vinegar exacerbates pain in stings from most species, it may be beneficial in treating stings by the Bluebottle jellyfish, also known as Portuguese man-o-war.
The most consistently effective treatment for stings from jellyfish species common to around beaches in the United States is careful removal of the nematocysts, followed by washing the afflicted area with water – hot is ideal, but saltwater is also effective – and application of topical lidocaine or benzocaine.
Researchers did not find sufficient evidence to support or refute the use of pressure bandages, which is recommended in some first aid manuals.
"The perfect treatment would be readily available, cheap, capable of inactivating venom and applicable across multiple species of jellyfish," said Dr. Ward. "Until that remedy is discovered, hot water or topical lidocaine may be the best bet for a jellyfish sting in North America or Hawaii."
Annals of Emergency Medicine is the peer-reviewed scientific journal for the American College of Emergency Physicians, the national medical society representing emergency medicine. ACEP is committed to advancing emergency care through continuing education, research, and public education. Headquartered in Dallas, Texas, ACEP has 53 chapters representing each state, as well as Puerto Rico and the District of Columbia. A Government Services Chapter represents emergency physicians employed by military branches and other government agencies. For more information visit www.acep.org.