Stinging from a jellyfish in children and adults
Injuries from jellyfish differ in intensity depending on the type of jellyfish. The migrating wire is common in our area, it has many hunting arms and it can cause a lot of discomfort. But in pediatrics it is always important to look at the half full glass and in this case remember that there are more dangerous and even deadly jellyfish in the world.
The jellyfish arms contain syringe-like stinging cells whose purpose is to paralyze the prey from which it feeds. Since the burn cells can release the venom long after the arms have been detached from the jellyfish body, it is possible to burn even if you have not physically encountered the entire jellyfish.
In children and adults, the burn is characterized by local reactions, and less often – systemic reactions.
Local responses – Pain, stinging (like a burn), itching and damage to the skin, usually in a linear shape (as a whiplash). Skin damage can appear in many forms – redness, urticaria, wheal reaction, blistering, pigmentation changes or even necrosis. See attached photos.
The local pain can remain for several days to weeks and in extreme cases can also lead to scarring or a change in skin tone in the area. Later we will learn how to avoid this.
Like any skin lesion, the area can become secondarily contaminated, so-called secondary bacterial infection. We will also learn to avoid this.
Systemic effects – Less common for the jellyfish in our country but may include fever, abdominal pain, fatigue and muscle aches. Sometimes a significant allergic reaction (anaphylaxis) is also uncommon.
What are the principles of treatment after a jellyfish stinging in children and adults?
A. Removal of the venom.
B. Neutralization of venom.
C. Supportive care including pain control.
And the most important principle – to do everything calmly and pleasantly. Stress and screams did not help any child recover from a sting of a jellyfish.
So how do you really treat children and adults after a jellyfish injury?
Removal of the venom – Mechanical removal with a stick or plastic and later rinsing with running water. There is debate in the literature about whether to use fresh water or salt water and whether to use warm or cold water. In summary of many research papers in this context it has been found that using warm running water can help more. But come on, there is no convincing answer to this question and I do not know people who carry a bottle of hot water with them to the sea. Therefore, I recommend rinsing with running water as soon as possible. Salt water is fine.
Neutralization of venom – At the end of the day, I do not really know a good and proven method to neutralize the venom. Using vinegar, alcohol, baking soda, urine or any other invention simply has not been proven to neutralize the venom better than the other. It is important to understand that some of the work in the literature on post-jellyfish interventions has been conducted elsewhere in the world, and involves other jellyfish, more or less violent and with non-identical mechanisms. Therefore, it is possible that in Australia the official recommendation is to put vinegar on the lesions of the local jellyfish while in our country it is not really a sweeping recommendation.
Supportive care – You can apply a soothing cream / illustration. I very much prefer in this regard In Pantene Plus (I swear I have no connection to the company) that can also disinfect the place and prevent secondary contamination. Cream with aloe vera? Also great. Penicillin ? Will help especially if it comes out of the fridge and is pleasant for a child / adult, usually will not help with the allergic because it is not an allergic reaction.
It is advisable to approach a doctor for examination in cases of systemic signs or on suspicion of a secondary bacterial infection in the stinged area.
Remember that in any area with a wound that may tan differently, apply sunscreen generously. This is so that there will be no unpleasant change in skin tone later on.
What not to do?
Do not rub or scratch the infected area. You may want to trim your children nails to reduce the chance of injury in the area.
In conclusion, a medical condition that is not pleasant at all, for children or adults, and can lead to prolonged discomfort.
Remember what is right to do, and see in the attached mythological video, what not to do …