For a jellyfish sting, rinse with vinegar, remove tentacles with tweezers, and soak in hot water. Don’t rub or use fresh water. Call 911 for severe reactions.
Steps
- Get out of the water.
- Rinse the sting with vinegar for 30 seconds (box jellyfish).
- Remove tentacles with tweezers or a card.
- Soak in hot water (104 to 113°F) for 20 to 45 minutes.
Don’t
Use fresh water, rub the area or use urine.
Call 911
For trouble breathing, chest pain or a sting from a box jellyfish, or large area.
Pain
Ibuprofen helps.
First-aid steps from health agencies
Rinse the sting site with vinegar for at least 30 seconds, which deactivates stinging cells of many species such as box jellyfish. For most other jellyfish, rinse with seawater, not fresh water, which can trigger remaining stinging cells. Remove tentacles with tweezers or a gloved hand. Then immerse in hot water at about 45 C (113 F) for 20 minutes, or use hot packs, to relieve pain.
- Do not rub the area, apply ice directly, use urine or ammonia, or use alcohol. These can cause more venom release.
- Pressure immobilization is advised for box jellyfish in Australia in some guidelines but not for most species elsewhere.
- Most stings cause pain and red welts that resolve in hours to days.
When to call emergency services
Call 911 for stings with trouble breathing, chest pain, swelling of the face or lips, a large area of body stung, confusion, or sting from box jellyfish or Irukandji. In Australia, call 000. Vinegar is recommended by Surf Life Saving Australia and the American Heart Association guidelines. Pain over a large area may need medical treatment.
First aid steps from health agencies
For most jellyfish stings, rinse the area with vinegar for at least 30 seconds if available, which deactivates stinging cells for box jellyfish and many others. Remove tentacles with tweezers or a gloved hand, not bare fingers. Then soak in hot water at about 45 C (113 F) for 20 minutes to relieve pain. Do not rub with sand, use fresh water or urinate on the sting. The American Heart Association guidance and Australian guidelines differ slightly for some species.
When to call emergency services
Call 911 for difficulty breathing, chest pain, widespread rash, severe pain, collapse or stings from box jellyfish, which can be life threatening. Seek care for stings covering a large area or on the face. Portuguese man o’ war stings are common on Atlantic beaches.
Species and treatment differences
Jellyfish stings differ by species. Box jellyfish stings in Australia and the Indo-Pacific can be fatal, and vinegar is recommended. For Portuguese man o’ war and Atlantic sea nettles, rinse with seawater, remove tentacles and use hot water, as vinegar may worsen discharge in some species according to some studies. Local guidance varies.
Pain relief and complications
Hot water immersion at 40 to 45 C for 20 minutes is effective for pain in many stings. Hydrocortisone cream and antihistamines reduce itching. Irukandji syndrome causes severe pain, high blood pressure and a feeling of impending doom, and needs hospital care. Call emergency services if the sting covers more than a limb or affects breathing.
Based on data from the American Heart Association and the Centers for Disease Control and Prevention
