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*Consider oral or parenteral analgesia for severe pain
*Consider oral or parenteral analgesia for severe pain
*Acetic Acid may inhibit or trigger nematocyst discharge and thereby increase or decrease pain depending on species  
*Acetic Acid may inhibit or trigger nematocyst discharge and thereby increase or decrease pain depending on species  
*'''Avoid  urine, ethanol, ammonia'''
*'''Avoid  fresh or tap water since it causes nematocyst discharge via the osmotic gradient'''
*'''Symptomatic treatment for Irukandji syndrome'''
*'''Symptomatic treatment for Irukandji syndrome'''
*'''Antivenom is available for severe box-jellyfish sting'''
*'''Antivenom is available for severe box-jellyfish sting'''
===Avoid===
*Urine, ethanol, ammonia
*Fresh or tap water (causes nematocyst discharge via the osmotic gradient)


==See Also==
==See Also==

Revisión del 02:25 20 ago 2016

Background

  • Jellyfish; Box Jelly is most deadly
  • Most toxic: Australia and other Indo-Pacific waters

Mechanism

Nematocyst stages of discharge
  • Physical contact or osmotic gradient causes discharge of neamtocysts
  • A spring loaded venom delivery system

Clinical Features

  • Isolated stinging
  • Severe
    • Respiratory paralysis, cardiovascular collapse, limb paralysis and death

Irukandji syndrome

Differential Diagnosis

Marine toxins, envenomations, and bites

Management

  • Remove tentacles and nematocysts
  • Hot water immersion
  • Consider topical lidocaine
  • Consider oral or parenteral analgesia for severe pain
  • Acetic Acid may inhibit or trigger nematocyst discharge and thereby increase or decrease pain depending on species
  • Symptomatic treatment for Irukandji syndrome
  • Antivenom is available for severe box-jellyfish sting

Avoid

  • Urine, ethanol, ammonia
  • Fresh or tap water (causes nematocyst discharge via the osmotic gradient)

See Also

References

  1. Ward NT, Darracq MA, Tomaszewski C, et al. Evidence based treatment of jellyfish stings in North America and Hawaii. Ann Emerg Med. 2012;60(4):339-414.
  2. Cegolon L, Heymann WC, Lange JH, et al. Jellyfish stings and their management: a review. Mar Drugs. 2013;11(2): 523-50