#KYJ - Bluebottle stings
It’s been a summer of bites and stings, and this week droves of bluebottles have hit the southern coast of Queensland and NSW causing countless stings to waders and swimmers.
The Bluebottle (Indo-Pacific) is a smaller colony of a larger group of marine stingers that are collectively called Portuguese Man-o-war.
Unlike the Box Jellyfish and the collective cuboid jellyfishes (yes ‘jellyfishes’) I wrote about last week - the Irukandji (16 diff species), the Bluebottle is not a jellyfish at all.
All that stings is not a jellyfish, corals, fish and even some molluscs have a sting.
Bluebottles are related to coral, and interestingly, they are not even one animal, but three different animals living together.
Look carefully, there is three individual polyps living together as one .
It’s a Trinity! These polyps are attached to one another and are not able to survive independently.
This is called obligate symbiosis. It’s like nurses and coffee, or accountants and calculators, or Trump and his Wall.
Each polyp works together to function like an individual animal. The sail or float, the Gauci and the Tenticles. Each start live as a separate animal, then “find” each other in a moment of serendipity or is that SEArendipity- sea what I did there!!
Anyhoo- the Bluebottle recently hit the news as weather patterns in East Coast of Australia caused armadas of thousands of these stingers into coastline locations. Thousands of reported and unreported stings have compounded a 10 year spike in suspected Irukandji stings.
What is important to note is that the venoms of these animals is very different. For our #Irukandji article scroll back to last week .
Bluebottle stings are intensely and immediately painful. The pain is described a whip like, and burning, unlike the Irukandji sting that is a deep muscular ache and delayed for 5-30 mins after sting.
Bluebottles have very few recorded deaths, but of those, it is thought to be anaphylactic airway swelling in people stung on their throat or neck.
Bluebottles stinging tentacles can survive days after they have been chopped up by passing boat propellers. This means that fragments of tentacle floating in water with swimmers congregate can still provide stings despite no intact bluebottles being seen washed up on the beach. Bluebottles either have a left or a right sided sail. This insures that irrespective of which way the wind blows half of the armada will be blown in that direction, insuring survival and distribution of the species .
Treatment:
We really don’t know what is the best treatment for bluebottles -many different reports and studies will have differing ideas. The standard first aid management is to first pick off or wash off the remaining tentacles with seawater. Must be seawater!!!
It is not recommended to use vinegar on bluebottle stings and is not recommended to use fresh water to wash off the sting, both of these have been demonstrated to increase the firing of undischarged stinging cells.
Hot water Vs Ice packs
The recommended first aid after decontamination is to immerse the stunning area in hot water. The water should be as hot as the person can stand without causing burning. For most people this means expediting them to a nice hot shower. Because the sting is immediately intense, and sensation in the stung limb is altered, it is reasonable to assist the stung victim by testing water temperature to avoid scalding- especially in children.
And alternate approach to the application of hot water, is the application of ice. If ice is to be used it must be covered with a wet cloth and applied for no more than 20 minutes at a time inspecting the skin regularly for the potential of ice burns.
Now the astute reader is going to be looking at the use of either hot water or ice as being almost completely opposite each other, the point of these treatments however, is to denature the venom which is a delicate heat sensitive protein.
My personal experience with bluebottles has revealed that the hot water option is fast and superior to using ice packs. It is also convenient to use hot water as all other fish stings require a hot water immersion as a first aid treatment.
In most first aid courses when the bites and stings session comes up, a first aid instructor will teach a simplified first aid management. My preference is to teach “if you were bitten on land or stung on the land use ice, if you were stung or bitten in the water use hot water as your first aid treatment, now this is just a rule of thumb, and of course doesn’t apply to deadly snakes spiders or box jellyfish. But as a general rule , Fish stings, fish bites,stingray barbs coral stings, anemone & ascidians stings and all jellyfish with the exception of box jellyfish, it is easy to simply remember one first aid strategy-hot water.
Exceptions.
Box Jelly fish /Irukandji- vinegar & hospital.
Sharks - well they are not venomous and so haemorrhage control is the focus.
Octopus/molluscs eg cone shell- treat as a snake bite with pressure immobilisation bandaging.
Clinical management:
There is evidence supporting ongoing ice application, and dermatitis topical treatments like hydrocortisone cream.
Analgesia should be liberal, and antihistamine use is very common and well supported.
Treat any anaphylactoid reactions with usual airway management and adrenaline protocols.
Blue bottles and their stings are a part of life in many coastal areas. Listed to and heed local weather forecasts and lifeguard warnings.
Have a first aid plan and obviously, if there are bluebottles washed up on the beach, don’t go swimming that day.
Be safe in the sun.
#RobTimmings
#Bluebottle
#ECT4Health
Our emergency management seminar “Whatmergency” covers common stings and bites :- more www.ect4health.com.au/whats
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