Stinger Treatment

New Treatment For Non-Tropical Bluebottle Stings – 16/08/2007

Hot water is now the recommended treatment for bluebottle stings, following scientific research and review by Surf Life Saving Australia (SLSA) and the Australian Resuscitation Council (ARC).

Each year trained surf lifesavers and lifeguards treat between 20,000 to 30,000 people for stingers, making SLSA the leading provider of bluebottle treatment in the country.

Dr Natalie Hood, SLSA’s medical advisor and a member of the ARC, said that an extensive review of all the scientific evidence published over the last 50 years had led the ARC, the peak authority for medical and first aid practices in Australia, to recommend the use of hot water for non-tropical bluebottle stings wherever possible.

‘For many years the ARC’s recommended treatment for bluebottle stings was the application of a cold pack or ice, however after extensive scientific review, the best available evidence is that hot water can offer improved pain relief,’ she said.

The newly approved treatment for non-tropical bluebottle stings is:

  • Don’t allow rubbing of the sting area
  • Pick off any remaining tentacles with fingers – a harmless prickling may be felt
  • Rinse the stung area well with seawater to remove any invisible stinging cells
  • Place the victim’s stung area in hot water – no hotter than the rescuer can comfortably tolerate
  • f the pain is unrelieved by the heat, or if hot water is not available, apply cold packs or wrapped ice

SLSA has endorsed hot water as the recommended treatment for bluebottle stings.

Tropical Stings

Stings by tropical jellyfish require completely different treatment, in particular the immediate calling of an ambulance and, if available, dousing the stung area in vinegar to neutralise any remaining stinging cells from injecting more venom into the skin.

Non-tropical treatment priorities are based on pain relief, because life-threatening stings are highly uncommon.
Thus, freshwater (hot or cold) will cause stinging cells to inject more venom into the skin, but this is of little medical consequence.
Tropical treatment priorities are based on saving a life, with pain relief as a secondary focus; vinegar does not relieve pain, but may save a life in the event of a Box Jellyfish or Irukandji sting.

SLSA’s Director of Lifesaving, Peter George AM, said that wherever it is logistically possible, surf lifesavers and lifeguards in non-tropical areas will have hot water available to treat patients, however if local circumstances don’t permit this, cold packs and ice can still be used as a second line option for pain relief.
’There are clearly some logistical challenges for surf lifesavers who generally operate in the middle of a beach without access to electricity,’ he said.
’Nevertheless, SLSA will work with all clubs and services to help implement the new treatment wherever it is possible.’

A fact sheet outlining this treatment is available here.