PHUKET NEWS TV: Jellyfish - Deadly or Dangerous?'

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PHUKET NEWS TV: Jellyfish - Deadly or Dangerous?'

A 5 year old boy was killed by one of these. Do you know how to treat jellyfish stings? We bet you are wrong.

Source: http://www.thephuketnews.com/phuket-news-tv-jellyfish-deadly-or-dangerous-48066.php


-- Phuket News 2014-08-27

[NomadJoe]

Blue bottles are not actually jellyfish, but a colony of animals. The recommendation for treatment of blue bottles after picking off any remaining tentacles as best you can is to then flush the affected area with sea water, not vinegar. Sea water, since it is the medium the animal lives in, is least likely to trigger the firing of additional nymatocysts that may be on the skin. In recent study's vinagar was found to make it worse. After the area is cleared of any further nymatocysts, hot water can be used for the pain. If no hot water is available, ice packs can be used. Do not rub sand on the affected area. Bluebottle stings, (and non-box jelly stings) are not life threatening unless on the face, neck or covering large portions of the body. The victim should also be monitored for any allergic reaction to the venom.

I have seen the lifeguards in Phuket use this local plant before, but I have never seen any evidence that it,or lemon juice, relieves pain or prevents further envenomation.

It is good advice that if you suspect you are stung by a box jellyfish, that it is an emergency and you need to be transported to a hospital immediately. Vinegar is recommended for jellyfish stings (but not blue bottles) including box jellies. Not all box jellies are lethal, but many are. They are very rare on the west coast,preferring the mangroves of the east coast where local researches often find them in their traps.

Here is a video of a box jelly I filmed off Kata beach last year.

And another.

These were sent to the PMBC and other sources outside Thailand, all of which confirmed they were box jellies, however the leathality of this species could not be determined without a specimen. I suspect they are not of the deadly variety since we have not had any confirmed cases of serious box jelly stings on the west coast. These two, and one other at the same location during the same month, (and also at night so they are very visible in the torch light), are the only ones I have every seen in Thailand in 13 years diving here. A few other instructors I know have seen the same at the same dive site.

Edited August 27, 2014 by NomadJoe

[JoeLing]

Until 2005, treatment involved using pressure immobilisation bandages.

This treatment is no longer recommended. Bandages to achieve tissue

compression provokes nematocyst discharge.

Until 2014, the application of vinegar was a recommended. This practice is

no longer recommended either after it was demonstrated that while vinegar

deactivates unfired nematocysts, it causes already-fired nematocysts to

release the remaining venom.

The NHS in the UK suggests [although not scientific proven] to apply

shaving cream to the affected area as it will help prevent the spread of

toxins. Use a razor blade, credit card or shell to remove any small

poisonous sacs that are stuck to the skin.

After carefully removing any remaining tentacles from the skin, thoroughly

wash the affected area with seawater (not fresh water). Afterwards, soak

the area in hot water to help ease the pain.

Researchers from James Cook University and Cairns hospital came to the same

conclusion, however, their website currently still says to use vinegar on

box jellyfish and Irukandji sting.

Some studies showed, that a zinc-based compound, sometimes taken to treat

the common cold, prevented death in mice injected with box-jellyfish venom.

The compound - zinc gluconate, a nutritional supplement - seems to work by

preventing certain ions that keep the heart beating from leaking out of

blood vessels.

Cold water shouldn't be used as first aid treatment as it shocks and triggers

nematocyst discharge. The use of other substances, such as urin, alcohol or

baking soda, should also be avoided.

Prevention is the best practice, just like with Malaria or Dengue.

Wear protective clothes and if in doubt, don't go in to the sea.

I personally still use vinegar or lemon juice against jelly stings or sea

urchins and have them always available in my first aid kit.

[iReason]

"Jellyfish - Deadly or Dangerous?"

Are the simpletons who wrote the story asking for an answer to that?

[NomadJoe]

"Jellyfish - Deadly or Dangerous?"

Are the simpletons who wrote the story asking for an answer to that?

It's just a headline.

You don't know what you are talking about. Tim has a lot of experience in journalism and presents a very decent piece here. He realizes, like many of us readers with experience in this field, that the lifeguards suggestions are out of date or inaccurate and attempts to politely provide the correct information.

[Loles]

The box jelly-fish is deadly, not question at all.

[12DrinkMore]

Until 2005, treatment involved using pressure immobilisation bandages.

This treatment is no longer recommended. Bandages to achieve tissue

compression provokes nematocyst discharge.

Until 2014, the application of vinegar was a recommended. This practice is

no longer recommended either after it was demonstrated that while vinegar

deactivates unfired nematocysts, it causes already-fired nematocysts to

release the remaining venom.

The NHS in the UK suggests [although not scientific proven] to apply

shaving cream to the affected area as it will help prevent the spread of

toxins. Use a razor blade, credit card or shell to remove any small

poisonous sacs that are stuck to the skin.

After carefully removing any remaining tentacles from the skin, thoroughly

wash the affected area with seawater (not fresh water). Afterwards, soak

the area in hot water to help ease the pain.

Researchers from James Cook University and Cairns hospital came to the same

conclusion, however, their website currently still says to use vinegar on

box jellyfish and Irukandji sting.

Some studies showed, that a zinc-based compound, sometimes taken to treat

the common cold, prevented death in mice injected with box-jellyfish venom.

The compound - zinc gluconate, a nutritional supplement - seems to work by

preventing certain ions that keep the heart beating from leaking out of

blood vessels.

Cold water shouldn't be used as first aid treatment as it shocks and triggers

nematocyst discharge. The use of other substances, such as urin, alcohol or

baking soda, should also be avoided.

Prevention is the best practice, just like with Malaria or Dengue.

Wear protective clothes and if in doubt, don't go in to the sea.

I personally still use vinegar or lemon juice against jelly stings or sea

urchins and have them always available in my first aid kit.

You do all the research and find out the current recommendations from the experts in this field.

Then amazingly you discount them entirely and still carry on with your own personal and no longer recommended remedies?

Unbelievable.

(And, although it is not mentioned here, peeing on the victim is also not recommended. It is a myth unfortunately still perpetuated by "professionals" aka scuba instructors and divemasters, who should know better.)

Read this and chuck out your vinegar.

http://www.smh.com.au/technology/sci-tech/vinegar-on-jellyfish-sting-can-be-deadly-researchers-20140408-zqs8b.html

"Vinegar may kill rather than cure victims of box jellyfish stings, Queensland researchers have found.

The remedy, used for decades to treat stings, causes up to 60 per cent more venom from the lethal jellyfish to be discharged into the victim"

Edited August 28, 2014 by 12DrinkMore

[JoeLing]

Until 2005, treatment involved using pressure immobilisation bandages.

This treatment is no longer recommended. Bandages to achieve tissue

compression provokes nematocyst discharge.

Until 2014, the application of vinegar was a recommended. This practice is

no longer recommended either after it was demonstrated that while vinegar

deactivates unfired nematocysts, it causes already-fired nematocysts to

release the remaining venom.

The NHS in the UK suggests [although not scientific proven] to apply

shaving cream to the affected area as it will help prevent the spread of

toxins. Use a razor blade, credit card or shell to remove any small

poisonous sacs that are stuck to the skin.

After carefully removing any remaining tentacles from the skin, thoroughly

wash the affected area with seawater (not fresh water). Afterwards, soak

the area in hot water to help ease the pain.

Researchers from James Cook University and Cairns hospital came to the same

conclusion, however, their website currently still says to use vinegar on

box jellyfish and Irukandji sting.

Some studies showed, that a zinc-based compound, sometimes taken to treat

the common cold, prevented death in mice injected with box-jellyfish venom.

The compound - zinc gluconate, a nutritional supplement - seems to work by

preventing certain ions that keep the heart beating from leaking out of

blood vessels.

Cold water shouldn't be used as first aid treatment as it shocks and triggers

nematocyst discharge. The use of other substances, such as urine, alcohol or

baking soda, should also be avoided.

Prevention is the best practice, just like with Malaria or Dengue.

Wear protective clothes and if in doubt, don't go in to the sea.

I personally still use vinegar or lemon juice against jelly stings or sea

urchins and have them always available in my first aid kit.

You do all the research and find out the current recommendations from the experts in this field.

Then amazingly you discount them entirely and still carry on with your own personal and no longer recommended remedies?

Unbelievable.

(And, although it is not mentioned here, peeing on the victim is also not recommended. It is a myth unfortunately still perpetuated by "professionals" aka scuba instructors and divemasters, who should know better.)

Read this and chuck out your vinegar.

http://www.smh.com.au/technology/sci-tech/vinegar-on-jellyfish-sting-can-be-deadly-researchers-20140408-zqs8b.html

"Vinegar may kill rather than cure victims of box jellyfish stings, Queensland researchers have found.

The remedy, used for decades to treat stings, causes up to 60 per cent more venom from the lethal jellyfish to be discharged into the victim"

Amazing isn't it? The same university that finds out that vinegar COULD POSSIBLY

cause more harm and MAY kill rather then cure (well at least in laboratory conditions)

do still recommend to use vinegar.

So, as long Universities and Health Authorities still recommend to use vinegar when stung

by box jelly fish, as long research doesn't say vinegar WILL cause more harm and DOES kill,

I will use vinegar or shaving foam as first aid treatment.

Absolute nothing amazing on that, unless you're easily amazed

YOUR QUOTE: (And, although it is not mentioned here, peeing on the victim is also not recommended....... )

MY QUOTE: The use of other substances, such as urine, alcohol or baking soda, should also be avoided ...

Isn't "urine" and "pee" the same where you come from?

Edited August 28, 2014 by JoeLing

[Phuketboy]

Nomad Joe answered this correctly in the very first post. No need to start fighting over what other people have suggested/researched when half the time it's because the reader has misinterpreted what the person was saying.

[Mudcrab]

The box jelly-fish is deadly, not question at all.

Which one? Chironex Fleckeri can be, and has killed a lot of people. I've been stung but I'm still alive!!

There are many types of box jellies.

[iReason]

<script type='text/javascript'>window.mod_pagespeed_start = Number(new Date());</script>

"Jellyfish - Deadly or Dangerous?" alt=wai2.gif width=20 height=20> alt=wai.gif width=20 height=20>

Are the simpletons who wrote the story asking for an answer to that?

alt=facepalm.gif>

It's just a headline.

You don't know what you are talking about. Tim has a lot of experience in journalism and presents a very decent piece here. He realizes, like many of us readers with experience in this field, that the lifeguards suggestions are out of date or inaccurate and attempts to politely provide the correct information.

"It's just a headline."

You mean of course, the (important) lead sentence to an article, which draws the reader into reading the story, right?

Deadly or Dangerous?

It's a bit redundant isn't it?

Rain: Wet or Precipitation?

And what's with the question mark?

[NomadJoe]

The box jelly-fish is deadly, not question at all.

Which one? Chironex Fleckeri can be, and has killed a lot of people. I've been stung but I'm still alive!!

There are many types of box jellies.

Correct, and many are not lethal. This was the response from multiple specialists I contacted both inside and outside of Thailand.

[Jimi007]

The box jelly-fish is deadly, not question at all.

Which one? Chironex Fleckeri can be, and has killed a lot of people. I've been stung but I'm still alive!!

There are many types of box jellies.

Correct, and many are not lethal. This was the response from multiple specialists I contacted both inside and outside of Thailand.

So to summarize, use vinegar for stings other than Blue Bottle (Portuguese Man of War) stingers? Correct Joe?

[Tapster]

@NomadJoe

Very interesting info, thanks Joe.

My wife and I regularly dive in the Phuket area. We haven't been in Phuket long though, so please can I ask your opinion:

Are stingers in general enough of a risk, year-round, to require full length skins or thin wetsuits when diving?

Many thanks.

[NomadJoe]

<script type='text/javascript'>window.mod_pagespeed_start = Number(new Date());</script>

"Jellyfish - Deadly or Dangerous?" alt=wai2.gif width=20 height=20> alt=wai.gif width=20 height=20>

Are the simpletons who wrote the story asking for an answer to that?

alt=facepalm.gif>

It's just a headline.

You don't know what you are talking about. Tim has a lot of experience in journalism and presents a very decent piece here. He realizes, like many of us readers with experience in this field, that the lifeguards suggestions are out of date or inaccurate and attempts to politely provide the correct information.

"It's just a headline."

You mean of course, the (important) lead sentence to an article, which draws the reader into reading the story, right?

Deadly or Dangerous?

It's a bit redundant isn't it?

Rain: Wet or Precipitation?

And what's with the question mark?

Nearly all jellyfish are dangerous, but not all are deadly. The headline is accurate. You comparison is not valid, as rain is both always wet and always precipitation.

What everyone has failed to mention, including me, is that in most cases one does not know what has stung them. So instead of worrying about vinegar or no vinegar, just use the universal treatment, sea water. The area can be shaved if needed. Once the area is clear of tentacles, if pain is a problem, them apply affected area in the hottest water tolerated. If no hot water is available, then ice packs can be used. Monitor the patient for shock. If a boxie is suspected, regardless of the victims condition, activate EMS. get the victim to professional medial care immediately. In Thailand the EMS number is 1669.

As Tim said, treatment suggestions are debatable and continually changing. If you are going to be in or around the ocean much, it's a good idea to keep up to date.

Edited August 29, 2014 by NomadJoe

[NomadJoe]

The box jelly-fish is deadly, not question at all.

Which one? Chironex Fleckeri can be, and has killed a lot of people. I've been stung but I'm still alive!!

There are many types of box jellies.

Correct, and many are not lethal. This was the response from multiple specialists I contacted both inside and outside of Thailand.

So to summarize, use vinegar for stings other than Blue Bottle (Portuguese Man of War) stingers? Correct Joe?

Correct, though there is a growing movement which advocates not using vinegar on box jelly stings either, but that was based on a single study under laboratory settings so protocols have not been changed yet. There jsut isn't enough data yet to declare anything conclusive. Sea water is best imo.

Over the years I have treated a lot of people with jellyfish stings with vinegar, (That is if I know it's not a blue bottle because the sting occurred on the dive and not at or near the surface) but it's almost always after the area has been cleaned and is free of remaining tentacles. So since the only thing vinegar does is disable nymatocycts, the pain relief the victim reports is largely psychosomatic, but I will still do it if they are complaining of pain and if it comforts the victim, since I know it isn't going to hurt them.

Edited August 29, 2014 by NomadJoe

[NomadJoe]

@NomadJoe

Very interesting info, thanks Joe.

My wife and I regularly dive in the Phuket area. We haven't been in Phuket long though, so please can I ask your opinion:

Are stingers in general enough of a risk, year-round, to require full length skins or thin wetsuits when diving?

Many thanks.

I have around 2000 dives around Phuket now and my experience has been the occasional slight, very local sting which goes away after several seconds. More annoying than anything else. Maybe a couple times I have had a sting which leaves a visible mark after the dive, but it goes away in minutes. As I alluded to in the previous comment, I have seen it quite a few times on other divers over the years, but it was all minor. No scarring or anything. I wouldn't worry too much about it.

I couple of times I have been caught in a bloom. If there is a bloom, you will probably see it before you get in, but certainly you will feel it and see it right away and so you can just exit the water.

[Tapster]

Cool, Joe, thanks!

[cottonpusher]

If Phuket thinks it has a problem have a look at this, it also says not to use vinegar;

http://www.news.com.au/national/bluebottle-jellyfish-blanket-parts-of-the-northern-beaches-coastline/story-e6frfkp9-1227040378802

[NomadJoe]

If Phuket thinks it has a problem have a look at this, it also says not to use vinegar;

http://www.news.com.au/national/bluebottle-jellyfish-blanket-parts-of-the-northern-beaches-coastline/story-e6frfkp9-1227040378802

Wow that is a lot of bluebottles. Last year I counted over 50 on Kata, but that was over the entire length of the beach.