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Treatment of Jellyfish Stings in UK coastal waters: Vinegar or Sodium Bicarbonate

Three Part Question

In [patients who have sustained a jellyfish sting from UK coastal waters], is [treatment with 5% acetic acid or sodium bicarbonate], [more effective at decontamination]?

Clinical Scenario

A six year old child in bathing trunks and towel attends the emergency department, howling with anxious parents. He has just been swimming in the sea and has large weals on his arm and leg from a common jelly fish sting which are very sore. You wonder what is the most effective way to treat this pain.

Search Strategy

Medline 1950 to June 2007. OVID interface.
[exp decontamination/ OR exp Sodium Bicarbonate/ OR exp bicarbonates OR exp Acetic Acid/ OR vinegar.mp. OR antivenin.mp. OR exp Antivenins/ OR baking soda.mp.] AND [exp "Bites and Stings"/ OR sting.mp OR exp Cnidarian Venoms/ OR exp Cnidaria/ OR jellyfish.mp. OR exp Venoms/ OR venom$.mp. OR chrysaora hyoscella.mp. OR compass jellyfish.mp. OR non stinging barrell.mp. OR root mouth.mp. OR rhizostoma octop$.mp. OR lions mane.mp. OR cyanea capillatum.mp.] AND [exp Treatment Outcome/ OR exp Prognosis/ OR outcome.mp. OR exp Outcome Assessment (HEALTH CARE)/ ] LIMIT to english

Search Outcome

325 articles of which none were relevant.

Comment(s)

No studies were found comparing the two treatments. Most studies have been done in Australia on Box Jellyfish stings, for which, vinegar is used to prevent stinging cells adherent to the skin from discharging.

Clinical Bottom Line

Vinegar has been shown to work in Australian jellyfish, but there is no data on bicarbonate use.