- Stings are associated with immediate burning pain, typically lasting up to 2 hours, and linear or elliptical erythematous welts
- Non‑specific systemic symptoms such as nausea, headache or malaise may occur.
- Stings are mild, self‑limiting and respond to first‑aid measures
- Reassure the patient
- Place under a hot shower for 20 minutes (ideal temperature 45ºC). The shower should be hot but not scalding or uncomfortable
- Administer simple oral analgesia such as paracetamol
- Do not apply a pressure immobilisation bandage (PIB) or vinegar, as this may worsen local symptoms
- Transport to hospital is not usually required
- None available.
- Pain associated with irukandji syndrome is usually delayed, severe and generalised. Significant linear dermal markings or welts are notseen
- Envenoming by the box jellyfish (Chironex fleckeri) is associated with immediate pain and obvious dermal markings (large welts). Tentacles may be seen adherent to the skin.
- Ice packs until recently were the recommended first‑aid treatment for stings. The superiority of hot water has now been conclusively demonstrated.
- Most patients do not require any care beyond first-aid
Loten C, Stokes B, Worsley D et al. A randomised controlled trial of hot water (45ºC) immersion versus ice packs for pain relief in bluebottle stings. Medical Journal of Australia 2006; 84(7):329–333. [Reference]