What should I do if I am bitten or stung by a sea creature?

If you are bitten or stung by a sea creature, the best first aid treatment depends on the creature involved.

Sea creature bites and stings can cause a severe allergic reaction (anaphylaxis) in some people. In cases of severe allergic reaction, the whole body can react to the bite or sting, which can lead to anaphylactic shock. Anaphylactic shock is very serious and can be life-threatening.

Symptoms of anaphylactic shock may include:

• difficult or noisy breathing
• difficulty talking and/or hoarse voice
• a swollen tongue
• persistent dizziness or collapse
• swelling or tightness in the throat
• pale and floppy (young children)
• wheeze or persistent cough

Sea creature stings can be life-threatening. If you or someone else is having trouble breathing, having a cardiac arrest or if someone is unconscious, call triple zero (000) immediately and ask for an ambulance.

Box jellyfish, Irukandji and other tropical stingers

Tropical stingers (jellyfish) live in tropical waters along the coastline of Northern Australia. The most dangerous are the box jellyfish and Irukandji.

The stinger season is at its highest from November to March.

The symptoms of a box jellyfish sting are:

• severe pain in the area
• seizure
• respiratory distress
• cardiac arrest

The symptoms of Irukandji sting are:

• severe backache
• headache
• shooting pains in the muscles
• chest and abdomen pain
• nausea or vomiting
• sweating
• anxiety, restlessness and breathing difficulties

To treat a sting:

• Call triple zero (000) and ask for an ambulance.
• Get help from a lifesaver or lifeguard if possible.
• If the person is unconscious, start cardiopulmonary resuscitation (CPR).
• Pour or spray vinegar onto the sting for at least 30 seconds.
• If vinegar is not available, pick off the tentacles and wash the area with sea water. Do not use fresh water.

Never substitute vinegar with methylated spirits, alcohol or fresh water — these substances they will make the sting worse.

Stonefish

Stonefish live all along the coast and in some fresh water. They are mainly found in the northern half of the Australian coast.

They look like rocks and live among rocks on coral reefs or in mud or sand. The stonefish’s back is lined with spines that release a venomous toxin. This makes it very dangerous.

Symptoms of a stonefish sting are:

• severe pain that quickly travels up the limb
• swelling in the area
• seizure
• paralysis

To treat a sting:

• Call triple zero (000) and ask for an ambulance and get help from a lifesaver or lifeguard if possible.
• Soak the affected area in hot water (about 45°C) for up to 90 minutes to relieve the pain.

The person may need treatment in hospital to further relieve their pain and to be given stonefish antivenom.

To protect yourself from stonefish stings, wear thick soled shoes and shuffle your feet when you walk on the reefs in northern Australia. Also, do not pick up rocks on reefs — they could be stonefish.

Blue-ringed octopus, sea snake and cone shell bites and stings

Bites and stings from the blue-ringed octopus, sea snakes and cone shells are very dangerous.

Symptoms may include:

• pain, swelling and numbness in the area
• muscle weakness
• changes in vision, speech and hearing
• trouble breathing

To treat a sting:

• Call triple zero (000) for an ambulance and get help from a lifesaver or lifeguard if possible.
• Provide CPR if needed.
• Wash off any tentacles with sea water.
• Put the person’s sting in hot water (no hotter than easily tolerated) for 20 minutes.
• Apply a pressure immobilisation bandage.
• Keep the person as calm and still as possible until medical help arrives.

Bluebottles and other jellyfish (non-tropical stingers)

Non-tropical stingers live in waters all around Australia’s coastline. Bluebottle stings are the most common jellyfish stings in Australia.

Symptoms are:

• intense pain straight away
• redness at the site

To treat a sting:

• Get help from a lifesaver or lifeguard if possible.
• Wash any tentacles off the skin with seawater, not fresh water.
• Soak the affected area in hot water (no hotter than can be easily tolerated) for 20 minutes to relieve the pain.
• See a doctor if the pain or symptoms gets worse.

Fish stings injuries

There are numerous venomous sea creatures. This includes fish and stingrays that have sharp, venom-filled spines on their back, underside or tail. When these spines stab into human skin, they release venom.

Symptoms include:

• severe pain in the area
• puncture wound
• bleeding
• swelling

To treat a fish or stingray injury:

• Remove any pieces of spine, unless it is a stingray spine.
• For pain relief, immerse affected area in water (or shower) as hot as patient can tolerate (45°C) for up to 90 minutes.

Sea urchin injuries

Most sea urchin injuries are from being stepped on or picked up.

Symptoms include:

• pain
• multiple puncture wounds from spines

To treat sea urchin injuries:

• Remove spines close to the surface.
• Immerse affected area in water (or shower) as hot as patient can tolerate (45°C) until the pain goes away, or for a maximum of 90 minutes.

Sponge injuries

Sponge contact reactions are uncommon and may be difficult to diagnose if the symptoms are delayed.

Symptoms include:

• pain
• itchiness
• numbness
• usually lasting for days

To treat sponge injury, wash the sting site.

How can I prevent bites and stings?

To protect yourself from marine stingers:

• Check signs for sea creature warnings.
• Swim at patrolled beaches between the red and yellow flags.
• Do not enter the water when the beaches are closed.
• Do not touch sea creatures.
• Ask a lifeguard for help or advice if needed.

In tropical waters, it is also recommended to:

• Swim inside stinger nets, if available.
• Wear a full body swimsuit for extra protection (particularly during stinger season).
• Enter the water slowly to give marine stingers time to swim away.

When should I see a doctor?

Most stings and bites will require medical attention from a doctor. Call triple zero (000) if you have a suspected sea creature sting or bite, or seek help from a lifesaver or lifeguard if possible.

Resources and support

See St John Ambulance Australia’s first aid resuscitation procedures (DRSABCD) poster for printable charts and their quick guide to first aid management of bites and stings.

Knowing what to do in an emergency can save a life. You can book a first aid course through St John Ambulance Australia or call them at 1300 360 455.

The Australasian Society of Clinical Immunology and Allergy has information on anaphylaxis and what to do if someone has a severe allergic reaction to bites and stings. ASCIA also advises how to set up a personal action plan.

The Australian Venom Research Unit has a guide to pressure immobilisation bandages used for bites to limbs.

The Australian Bites & Stings app contains first aid instructions on what to do if bitten or stung by a venomous creature, and is free to download.

You can call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available 24 hours a day, 7 days a week.