Lionfish Sting First Aid and Treatment
If you are “stung” by a lionfish: DONT PANIC!
You are most likely not going to die, though you might wish you had depending upon how many spines penetrated the skin, the depth of the puncture, your own tolerance to pain and your body’s physical reaction to the venom. For most people the throbbing, intense pain is going to last for a few hours and will remain less painful for 12 hours or longer. One thing is for sure, everyone reacts differently and has a different experience.
It is important to note that when we refer to “lionfish sting” we are actually talking about having one of the lionfish’s 18 venomous spines puncture the skin and causing a wound deep enough to allow the venom that coats the spines to enter the body and go to work.
Lionfish Sting Response and First Aid
If you are diving you must get to the surface and onto land or a stable platform in a safe and controlled manner. Most divers (the author included) report that the pain does not come on immediately and the venom takes several minutes to begin to work. Let your dive buddy know that you have been stung and call the dive. It is important to work out a signal for being stung to use underwater if you will be hunting or handling lionfish. We use a “finger gun” pointing to the wound area, then a thumbs up. Keep in mind that a diving related injury like decompression sickness or lung embolism is far more dangerous and likely to cause death than the sting.
Remove Remaining Spines
Inspect the wound closely for any signs that pieces of the spine might have broken off and are still in the skin. Gently remove them if you are able.
Clean and Disinfect Wound
Using clean, freshwater flush the injured area as completely as possible. If you have a first aid kit available disinfect the wound with antiseptic towelettes and apply triple antibiotic ointment if possible.
If necessary, apply direct pressue to the wound in order to stop the bleeding.
Apply Non-Scalding Hot Water
Even though you will probably start to see swelling of the injured area, DO NOT APPLY ICE. The venom is protein-based and begins to breakdown with the application of HEAT. Heat will bring a noticeable relief to the pain and shorten the effectiveness of the venom. For this reason we always advise that a thermos of hot water be taken on any trip in which contact with lionfish is possible. Keep in mind that sources of hot water may also come from boat engine cooling water exhaust or water heated in a metal container on top of an engine block. Many resources will tell you that the water needs to be between 100°-115°F, but there really is no practical way to measure that or time to get water to the correct temperature in most instances. Immerse the wound in water that is as hot as the victim can stand without scalding or burning the skin. Soak for at least 30 minutes but as long as desired. If the affected area cannot be immersed then apply clean cloths soaked in hot water and change out or re-soak frequently to keep the heat up. If you do not have hot water available, then heat packs will also work; they are an important item to include in any marine first aid kit.
Take Pain Medication
If the victim can tolerate over the counter pain medications, now is a good to time take them.
Seek Medical Treatment
While many people do not seek medical treatment for a lionfish sting, we HIGHY RECOMMEND that you do. Not only do treatment facilities have access to some really nifty pain medications that you WILL want, there can be other complications that aren’t immediately apparent, too:
- Severe pain can cause shock which may involves shortness of breath, weakness, fainting and cardiac arrest.
- Diabetics and those with compromised immune systems may react very badly to the venom and it’s systemic effects.
- There is a very real possibility that people who are allergic to the venom may go into anaphylactic shock. Many people die every year from anaphylaxis.
- There may be pieces of spine left in the wound that you cannot see without an X-ray or other inspection.
- There is ALWAYS the chance that any injury caused by a marine creature can become terribly infected.
- There has been at least one case of paralysis in both arms and legs of a home aquarist who was stuck in the finger. The paralysis went away completely in a short time, but it was a good thing he had sought medical treat when the symptoms of envenomation began to grow worse.
- Lionfish venom can cause tissue necrosis (tissue death) that has the ability to spread if not treated immediately when identified.
- Of course, there are many other issues that could come up. (We’re hunters NOT doctors.)
You can also call the Poison Control Hotline at 1-800-222-1222. The Aquatic Toxins Department is available 24 hours a day. Everyone is welcome to call and multiple languages are supported however this is not a toll-free call from outside of the United States – 011-800-222-1222.
When you’ve lived through it and you are back in the water lionfish hunting again, say, “Hi!” to the next one you spear…