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First Aid Treatment


Treatment of Jellyfish stings with Cold packs or Ice.

Large stings.

Treatment of Chironex and other Box Jellyfish stings.

Treatment of Marine creature stings by Hot water.

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Cold packs or ice (wrapped in a cloth) are very effective, applied to the area of a jellyfish sting to relieve local skin pain. It is the first aid treatment of choice. They may be used if no other treatment is available for Chironex Box Jellyfish stings, but are less effective because of the severe pain, and deep tissue destruction.

Firstly, remove any remaining adherent tentacles by washing with water.

Warn victim that ice pack may be uncomfortable at first!

Wrap cold pack or ice in a wet cloth and apply directly over the sting site for 10-20 minutes (apply only to stung area to avoid hypothermia - especially small children).

Reassess pain and reapply cold pack or ice if necessary.

Send for medical assessment if cold fails to relieve pain, or other symptoms develop.


If a sting covers a large area, particularly if the victim is cold or wet, using a large number of cold packs, or packing the area with ice may encourage hypothermia.

In these cases "ice massage" seems to help. A small block of ice is held with a glove, or grasped with a cloth, and rubbed by the first-aider all over the stung area for 10-20 minutes, or until pain relief occurs. At the same time the rest of the body can be kept warm with blankets or clothing.

If this simple treatment is not effective the patient is referred to medical help.

First aid treatment of chirodropid envenomation.

1. Retrieve the victim from the water and restrain them, if necessary.

2. If others are available, immediately send them for ambulance / medical help (emphasise the sting is from a Box jellyfish as the Ambulance may have antivenom available).

3. Check the victims Airway, breathing and circulation (ABC). Treat with mouth-to-mouth resuscitation (EAR), or heart massage (CPR), if necessary.

4. If others are available, or if resuscitation is not needed, pour vinegar over the stung area for a minimum of 30 seconds to inactivate remaining stinging cells on any adherent tentacles left on the skin.

5. AFTER vinegar application, apply compression bandages directly over major stings, ie. those:
a) covering an area more than half of one limb
b) causing impairment of consciousness
c) causing impairment of breathing
d) causing impairment of circulation
If vinegar is unavailable, the rescuer should pull tentacles off using their fingers (only a faint, harmless prickling will be felt) - before applying the compression bandages. REMEMBER to wash your hands after this as sting cells will remain on your fingers until they are carefully washed off!

6. If available, use CSL Chironex antivenom for all major cases (see above). Three ampoules each containing 20, 000 units may be given intramuscularly, above the bandages, by a trained health professional on the beach. One ampoule intravenously may be given by medical personnel.

7. Cold packs may be used (15 minutes and repeated when necessary) to help ease the skin pain in conscious victims.

8. In severe envenomation, use oxygen if available; Inhaled analgesia (ie entonox or penthrane) can be administered for unremitting pain in conscious, breathing, cooperative patients; its use should be discontinued if the patient's condition worsens.


1. First, test the temperature of the water with your own limb. Because of the pain of envenomation, the victim's may be unable to feel the heat of the water with the affected limb; a severe or painful burn could result!

2. After the water has been tested, the affected limb is immersed in hot water until the pain is reduced, or relieved.

3. It may be necessary to change the water, or `top it up' several times - don't forget to test each time!