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Medicine for the Outdoors

Dr. Paul Auerbach is the world's leading outdoor health expert. His blog offers tips on outdoor safety and advice on how to handle wilderness emergencies.

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StingMate

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As many of you know, I serve as a medical advisor to the Diver's Alert Network (DAN) regarding incidents involving hazardous marine animals. This includes jellyfish (and related animals) stings.

I'm always on the lookout for new therapies or modifications of existing therapies to treat marine stings (envenomations). At a recent gathering of Beneath the Sea, I was introduced to Smithwick's StingMate intended for jellyfish sting first aid. The product is composed of 5% acetic acid gel containing menthol. Acetic acid 5% is usually the concentration found in household vinegar, and menthol is a component commonly used in topical anti-itch preparations. StingMate is sold in a 4 fluid ounce manual spray bottle. The instructions that accompany the product are standard for proper first aid treatment of a jellyfish (or related species) sting:

1. Apply the StingMate gel
2. Scrape the skin to remove the stinging cells (nematocysts)
3. Reapply the gel
4. Rinse the skin

I would annotate these instructions to allow an initial decontamination time (first application of the gel) to be a minimum time of two minutes. In terms of scraping the skin, the standard dictum is to apply shaving cream (foam) and use a straight-edge razor or very sharp edge to scrape the cream from the skin. The reapplication of gel should once again be for at least a few minutes.

How vinegar is effective is not without some controversy. Most authorities believe that it renders the stinging cells inoperative, so that they cannot fire. That makes the most sense, because it is unlikely that the vinegar could penetrate the skin and neutralize active venom, although it is possible that vinegar might inactivate surface venom that it is able to reach. The important thing is that vinegar is an effective remedy and absolutely essential to treat the stings of most of the world's most hazardous (and potentially lethal) jellyfish, such as the Indo-Pacific box jellyfish. I have used vinegar effectively for years, so I have every expectation that StingMate will prove to be a clinically useful product.

Oceangoers should be aware that allergic reactions to jellyfish stings are possible, so should also carry allergy medications or an allergy kit with their first aid supplies.

Preview the Annual Meeting of the Wilderness Medical Society, which will be held in Snowmass, Colorado July 24-29, 2009.

Join me from January 24 to February 2, 2010 for an exciting dive and wilderness medicine CME adventure aboard the Nautilus Explorer to Socorro Island, Mexico to benefit the Wilderness Medical Society.

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About the Author

Dr. Paul S. Auerbach is the world’s leading authority on wilderness medicine.

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