OTHER COMMON NAMES
"Box-jellyfish". Often referred to as “Stingers”, rarely as the "Sea wasp". These latter names should NOT be used - the word “Stingers” can mean any stinging jellyfish in the sea and we must be more specific as this jellyfish causes severe stings and even death. The second name is old-fashioned and confuses people – making them think that this is a creatures that flies over the water rather than exists below it.

SYMPTOMS & SIGNS

	Instant, and severe burning skin pain. Sting marks look like whip marks, or may resemble burn marks on the skin.
	Adherent tentacles are often still present.
	`Frosted-ladder' pattern may be visible.
	Victim may rapidly lose consciousness and stop breathing.
	The pulse may become irregular, or stop.

FIRST AID TREATMENT OF CHIRONEX & OTHER BOX JELLYFISH STINGS
First aid treatment of chirodropid envenomation:

	1. Retrieve the victim from the water and restrain them, if necessary.
	2. If others are available, immediately send them for ambulance / medical help (emphasise the sting is from a Box jellyfish as the Ambulance may have antivenom available).
	3. Check the victims Airway, breathing and circulation (ABC). Treat with mouth-to-mouth resuscitation (EAR), or heart massage (CPR), if necessary.
	4. If others are available, or if resuscitation is not needed, pour vinegar over the stung area for a minimum of 30 seconds to inactivate remaining stinging cells on any adherent tentacles left on the skin.
	5. AFTER vinegar application, for SMALLER* stings, then: - a) apply cold packs or ice, wrapped in a polythene bag. This greatly helps the burning pain but takes a little longer than usual to work (because of the severity of the skin pain). b) Compression bandages and immobilisation (pressure immobilisation bandaging) is unnecessary. * A Major sting is defined below, smaller stings are for the stings that cannot be classed as “major”. Major stings are rare. Definition of a MAJOR sting is one: - a) covering an area more than half of one limb b) causing impairment of consciousness (i.e. drowsy or unresponsive) c) causing impairment of breathing (poor breathing effort) d) causing impairment of circulation (weak or irregular pulse) TREATMENT of a MAJOR STING: Steps 1-4 above, as before (i.e. after vinegar application for 30 secs), 5) apply compression bandages - firstly, directly over stung area, then apply compression bandage from the toes to the groin and immobilise the limb (tie both legs together, preferably with splint between the two) – i.e. pressure immobilisation bandaging. The pressure of the bandage is about the same as one applied to a sprained ankle.
	6. If available, use CSL Chironex antivenom for all major cases (see above). Three ampoules each containing 20, 000 units may be given intramuscularly, above the bandages, by a trained health professional on the beach. One ampoule intravenously may be given by medical personnel. Again, make sure someone has phoned for the ambulance and requested antivenom (only Queensland State Ambulance carry Chironex antivenom).
	7. Cold packs may be used (15 minutes and repeated when necessary) to help ease the skin pain in conscious victims.
	8. In severe envenomation, use oxygen if available; Inhaled analgesia (ie entonox or penthrane) can be administered for unremitting pain in conscious, breathing, cooperative patients; its use should be discontinued if the patient's condition worsens. If vinegar is unavailable, the rescuer should pull tentacles off using their fingers (only a faint, harmless prickling will be felt) - before applying the compression bandages. REMEMBER to wash your hands after this as sting cells will remain on your fingers until they are carefully washed off!

"Irukandji" Stings

(for further information on Irukandji click here )

DISTRIBUTION
Tropical Australian and Indo-Pacific waters. Found out to sea, and on Great Barrier Reef. At times may occur in "epidemic proportions" close to shore.

SIZE AND APPEARANCE
Small transparent jellyfish, usually never seen. A box-shape' jellyfish 1.5-2.5cms across bell with 1 tentacle only in each corner. The tentacles may be a few centimeters to 60cms. in length.

Click Images to Enlarge

SYMPTOMS & SIGNS

	Initial minor sting. The stung area may have "goose-pimples" or localised sweating.
	The sting is followed by a characteristic time delay of 5-40 minutes (usually 25-30mins.)
	After the delay then severe backache, muscle cramps, sweating, nausea, headache and a dreadful feeling of anxiety and ill health occur.

TREATMENT OF IRUKANDJI STINGS

	Application of vinegar for 30 secs
	Observation of airway, breathing, circulation.
	Rest and re-assurance.
	Send for ambulance / medical aid.
	Transfer to Hospital.

TAMOYA sp.

DISTRIBUTION
Tropical Australian waters, all Qld. and northern NSW coasts - usually an `open-water' jellyfish.

OTHER COMMON NAMES
"Morbakka", "Fire Jelly", "Moreton Bay Stinger".

SIZE AND APPEARANCE
Large transparent box-shaped jellyfish with one tentacle in each corner. Bell 6-18 cms height having thick, ribbon-shaped tentacles that may be up to 1 meter long.

Click Images to Enlarge

SYMPTOMS & SIGNS

	Burning, itchy pain at sting site.
	Wide, raised pink wheals with surrounding bright red skin flare.
	Rarely an "Irukandji-type" syndrome may occur.

TREATMENT:

	Douse any adherent tentacles with vinegar.
	Cold pack applied over a tissue or cloth, or apply ice wrapped in a wet cloth directly over the sting site for 10-20 minutes.
	Reassess pain, then reapply cold pack or ice if necessary.
	Send for medical assessment if cold fails to relieve pain, or other symptoms develop.

Carybdea rastoni - "Jimble"

DISTRIBUTION
Australia-wide.

SIZE AND APPEARANCE
Transparent bell with diameter 1.5-3.0cm. Four tentacles, one in each corner,
5-30cm long.

SYMPTOMS & SIGNS

	Thin, raised white wheals surrounded by bright red flare. Itchy, but USUALLY with little skin pain.
	Occasionally quite marked local skin pain.

TREATMENT

	Douse any adherent tentacles with vinegar (usually there are none present).
	Cold pack applied over a tissue or cloth, or apply ice wrapped in a wet cloth directly over the sting site for 10-20 minutes.
	Reassess pain, then reapply cold pack or ice if necessary.
	Send for medical assessment if cold fails to relieve pain, or other symptoms develop.

Pelagia sp. - "Little Mauve Stinger"

DISTRIBUTION
Although this jellyfish is very common in the Mediterranean, where it may appear in plague proportions, in recent years it appears to be less common in Australian waters.

SIZE AND APPEARANCE
A small mushroom-shaped body from 4-12cm in diameter. Unlike most jellyfish, the bell is covered with numerous warty lumps containing nematocysts (stinging cells). It is one of the few jellyfish in which contact with the bell may cause a sting. The bell is usually a pink or mauve with 8 pale brown tentacles 10-30 cm. in length.

Click Images to Enlarge

SYMPTOMS & SIGNS

	The sting is usually locally painful in the stung area, and has irregular shaped raised wheal, looking like an allergic reaction.
	Sometimes painful, or difficult breathing may occur.

TREATMENT

Chrysaora sp. - "Sea Nettle"

DISTRIBUTION
Common Worldwide, but less common in Australia. Described in Cockburn Sound, Swan River and Perth beaches in Western Australia.

	Cold pack applied over a tissue or cloth, or apply ice wrapped in a wet cloth directly over the sting site for 10-20 minutes.
	Reassess pain, then reapply cold pack or ice if necessary.
	Send for medical assessment if cold fails to relieve pain, or other symptoms develop.

Chrysaora sp. - "Sea Nettle"

DISTRIBUTION
Common Worldwide, but less common in Australia. Described in Cockburn Sound, Swan River and Perth beaches in Western Australia.

SIZE AND APPEARANCE
Up to 25cm bell diameter and 24 tentacles around the margin.

SYMPTOMS AND SIGNS

An unpleasant sting that causes a burning skin pain, burning throat, coughing and possibly a profuse watery nasal discharge.

TREATMENT

	Cold pack applied over a tissue or cloth, or apply ice wrapped in a wet cloth directly over the sting site for 10-20 minutes.
	Reassess pain, then reapply cold pack or ice if necessary.
	Send for medical assessment if cold fails to relieve pain, or other symptoms develop.