Is hot water immersion an effective treatment for marine envenomation?

Stonefish “Okoze” Envenomation during Food Preparation

“…Studies have concluded that hot water soaks are effective in controlling the pain in 74% of cases. 2,4 In the present case, hot water immersion was performed for 30 min, and the patient's pain subsequently disappeared after 18 h.…”

“…Thus, a hot water bath used in the absence of concomitant prophylactic antimicrobial agents may raise the subcutaneous temperature of the affected area and consequently facilitate the activity and proliferation of those microbes. 2,7 Therefore, administration of antimicrobial chemotherapy before or during hot water immersion should be considered, although prophylactic antimicrobial chemotherapy has been controversial. In the present case, despite the absence of antimicrobial chemotherapy, there was no bacterial infection on the finger.…”

“…Each stonefish has 13 dorsal spines, and each spine is connected to a pair of venom glands capable of producing a very potent but heat-labile venom. 1,2 The venom contains a proteinaceous toxin, which initially causes severe pain around the site punctured by the fins. It has also been reported to be myotoxic, neurotoxic, vasopermeable, and cardiotoxic.…”

Lion (Fish) on the Loose in the Waters off St Vincent!

“…"Dry stings" in which no venom has been injected have been described (4). To inactivate the heat-labile protein, treatment for lionfish envenomations include immersion in nonscalding hot water (~45°C) for 30−90 minutes or until pain is relieved (5). Opioids and local lidocaine, bupivocaine or sodium bicarbonate may be helpful.…”

Guidelines for Bystander First Aid 2016

“…(99,100) For pain relief, jellyfi sh sting should be treated with hot water immersion (45 o C or as hot as tolerable) for at least 20 minutes or for as long as the pain persists. (101)(102)(103)(104) (j) Dental injuries: Seek rapid medical consultation following tooth avulsion. Immediate re-implantation of an avulsed tooth within an hour provides the greatest chance of tooth survival.…”