Effective Treatments for Jellyfish Stings
Condition: Jellyfish Stings
MeSH terms: Bites and Stings
Study type: Interventional

Summary: 
      The purpose of the study is to attempt to determine which treatment from commonly used
      treatments is the best at reducing pain and redness of the skin after a sting from a
      Portuguese Man of War, Chrysaora chinensis, or Chrysaora fuscescens.

      Jellyfish stings are a common occurrence in many parts of the world causing significant
      morbidity to persons stung by jellyfish while participating in marine activities whether
      commercial or recreational. Much debate and confusion exist both in the medical literature
      and the common recommendations regarding how to treat persons stung by jellyfish.
      Specifically concerning what topical treatments are most efficacious at decreasing
      envenomation by nematocyst on skin, preventing the firing of un-discharged nematocyst,
      decreasing inflammation and pain resulting from envenomation by nematocyst. Antidotal
      recommendations and past studies have referenced numerous different topical treatments for
      jellyfish stings including but not limited to vinegar, urine, alcohol, distilled spirits,
      ammonia, bleach, acetone, bicarbonate slurry, lidocaine, meat tenderizer, Coca Cola, old
      wine, salt water, cold packs, hot water, and commercial products such as Stingose and
      Stingaid. Conflicting data exists regarding what works and what does not for nematocysts
      discharge, skin erythema, and pain reaction.

      The investigators would like to investigate which treatment is best out of some of the more
      commonly studied treatments for reducing pain and erythema.

      The investigators would like to complete a research study to try to bring some reasonable
      evidence to the field treatment of jellyfish stings, namely, the decontamination process
      (e.g., what can you put on a jellyfish sting that will be helpful, based on real data?).

      The questions asked are as follows:

        -  What topical treatments for jellyfish stings actually decrease the amount of
           inflammation seen on a macroscopic level on the skin of humans?

        -  What topical treatments for jellyfish stings actually decrease the sensation of pain in
           humans?

        -  Do topical chemical treatments cause different outcomes when exposed to the above
           parameters?

        -  Do different species of jellyfish nematocysts react differently based on the type of
           topical chemical treatment used? What is the variation of effects of topical treatments
           based on the species of jellyfish sting?

      Specifically, the investigators will be stinging human subject on both arms with a segment of
      tentacle for approximately 2 minutes. This will be followed by no treatment on one arm
      (control arm) and by treatment on the other arm with either: acetic acid (5%), sodium
      bicarbonate slurry (50%), papain slurry (70%), ammonia (10%), viscous lidocaine (4%),
      isopropyl alcohol (70%), or hot tap water (40 degrees Celsius). Outcomes measured will
      include pain and erythema.
    


Intervention name(s): Acetic Acid (5%); Sodium Bicarbonate Slurry (50%); Papain Slurry (70%); Ammonia (10%); Lidocaine (4%); Isopropyl Alcohol (70%); Hot Tap Water (40 degrees Celsius); No treatment
Intervention type(s): Other; Other; Other; Other; Drug; Other; Other; Other
Other intervention name(s): Vinegar; Adolfo's Meat tenderizer; Household ammonia; Liquid Lidocaine; Rubbing alcohol; Hot Water; Nothing is given topically to treat sting. This is the control.
Intervention MeSH terms: Ethanol; Acetic Acid; Retinol acetate; Lidocaine
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Triple (Participant, Care Provider, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Jellyfish stings; Treatment; Humans; Topical Treatments; Pain; Erythema