Getting into Hot Water

There is great variety in the number of proposed treatments for marine envenomations where an animal as either given a surface sting (the stingers of a jelly fish as well as anemones and stinging coral) or punctured the skin by either a wound or bite from either spines or teeth (sea urchins, star fish, stingrays, weaver fish, sea snakes and certain octopi). Often the victim doesn't see the offender and must begin first aid without knowing what fully happened.

Many intriguing treatments have developed and include application of heat, cold, vinegar, fig juice, meat tenderizer and urine!

The ABC's of first aid apply to marine envenomations as well. First, Assess the injury and based on local help try to find out what happened. If a wound is bleeding it is wise to leave the water as blood can attract sharks. Always ensure your own safety then the injured victim.

If a tentacle or barb is in place it is a good idea to remove it unless it is deeply embedded in a vital area. Having a physician or surgeon remove it is best if bleeding could restart. But in most cases the wounds are shallow and this is not a concern.

Carefully remove any jellyfish tentacles or similar debris. Portugese Man O War stings have potential to precipitate a drowning. Disturbing these too much may trigger the “nematocyst” stingers to discharge more venom. Some divers carry a knife or plastic scraper that they can use to scrape off this debris. Use gloves to removed tentacles.

Jellyfish are salt water organisms so throwing fresh water on a stinger will also cause it to discharge!

That is why rinsing with salt water is better and it is unnecessary to use urine. Vinegar is also recommended.

Immersing bites and stings in hot water is becoming an accepted first aid response to bites and stings. The area should have heat applied but not boiling or scalding water, as this will cook the person not heal them. Temperatures above 50 degrees are felt to denature the venom proteins and also modulate the pain response.

Having a medical person examine the wound is important as some venoms will cause the tissue to die (necrose). In this case antibiotics alone will not help and the person really needs to be under medical care especially from toxins from cone shell stings, blue octopus bites and lion fish/ scorpion fish. Stonefish, and box jellyfish poisonings may actually kill people and urgent medical care is needed. Ironically these are some of the most attractive sea creatures and many people bitten were getting too close.

Any marine cut or scrape may get infected with bacteria that cause severe infections. Only some antibiotics are effective in this case and may be prescribed by a doctor reviewing the wound.

One of our patients relates how she had swam out far from the beach while the tide was coming out causing her to be stranded. She then walked onto fire coral on the way in. She developed severe burn like skin eruptions that lasted over 10 days. Standing on coral destroys it and is one of the problems with allowing tourists to certain beaches.

Special thanks to Mr Jim Yankowski, President of the Underwater Council of Manitoba for his assistance in this article. Jim will be presenting “Red Sea Scuba”on March 21 st on7pm

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