a b s t r a c tCurrently the Australian Resuscitation Council (ARC) recommends dousing with vinegar followed by ice as first aid for jellyfish stings in tropical Australia, with limited evidence to support this recommendation (Li et al., 2013). We report our successful experience in using hot water immersion as first aid in treating two people stung by venomous tropical Australian jellyfish, one by Chironex fleckeri and one by Carukia barnesi.© 2016 Elsevier Ltd. All rights reserved.
Clinical recordA 35 yo M cinematographer was filming documentary on Irukandji jellyfish at Palm Cove, Queensland. He was coming to the shore holding a camera housing, and removed his glove to lift the housing out of the water. As he placed his left hand underwater he contacted a jellyfish, where the tentacle ran from œ way down the extensor surface of his forearm, running around the web space of his L hand across his palm and then between the ring and middle finger, and ending dorsally at the wrist joint. It was estimated to be 30 cm of tentacle, which was typical for Carukia barnesi.Within 5 minutes his entire forearm and hand was immersed in hot water (as hot as he could tolerate) in a plastic container. This was left there for about 20 minutes, with the water being replaced several times as soon as the water cooled.He was taken to the ED at Cairns Hospital, was observed for 5 hours and did not require any analgesia medication.The jellyfish, wrapped around the victims arm, was captured and later identified as Carukia barnesi.A 40yo M biologist was at Palm Cove collecting Box jellyfish (Chironex fleckeri). Whilst collecting one animal, he was stung across both hands and fingers on both the dorsal and palmer aspects by a Chironex fleckeri box jellyfish with a bell 25cm diameter. He had immediate severe pain, which the patient described 'brought him to tears'. He immediately rubbed his hands in wet sand and within 5 minutes he placed both hands in a plastic container of hot water (as hot as he could tolerate) for about 10 minutes. He had almost immediate relief of pain, and the severe pain recurred as the water temperature cooled and had the hot water replaced about four times. After ten minutes the pain had settled and was minimal, although he had marked swelling of his hands that settled over 48 hours. He required no analgesia medication. He had no permanent scarring.