Assessment and Management of Jellyfish Stings

Severity Assessment

• Most jellyfish stings in North America produce only localized skin symptoms; however, severe local reactions and systemic envenomation (e.g., respiratory distress, shock, intense pain) can occur, requiring close monitoring. 1
• Patients should be observed for systemic signs such as difficulty breathing, hypotension, or severe pain, and emergency medical services should be activated promptly if these develop. 2

Pathophysiology of Swelling

• Post‑sting swelling and lymphangitis are mediated by inflammatory release rather than bacterial infection, indicating that routine antibiotic therapy is unnecessary unless secondary infection is documented. 3

First‑Aid Recommendations (2025 Guidelines)

• The initial step is to rinse the affected area with seawater to deactivate and remove residual nematocysts; this is a strong recommendation. 4
• Tentacles should be lifted or pulled away without direct hand contact; if mechanical removal is not feasible, a seawater rinse serves as an alternative method. 1
• Immersion or irrigation with heated water at 40–45 °C (104–113 °F) provides analgesia after tentacle removal; this is a weak recommendation. 5