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Lionfish Sting First Aid and Treatment

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If you are “stung” by a lionfish: DONT PANIC!

Lionfish Sting First Aid Response and TreatmentYou 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

Surface Safely
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 lionfish sting signalbuddy 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.

Control Bleeding
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…

Giving the Finger to a Dead Lionfish

About the Author:

L. Scott Harrell is the former Executive Director and co-founder of the World Lionfish Hunters Association. He now works with restaurants and dive centers to develop lionfish related profit centers. Scott has been a scuba instructor since 1995.

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  1. The Best Day | Mauritius | September 18, 2014
  1. Kathleen Foland says:

    Hello, i want to learn more about lionfish and the potential culinary uses especially in Belieze as a location. Thank you

  2. Cathy Julian says:

    We have a portable electronic heat and cold pack that heats to 112 Fahrenheit. We are interested in promoting into the diving industry and will be at the dema show this week. Will you be there?

  3. jeff luft says:

    Was stung today while snipping off spines.. on my pointer finger. I continued to hunt till I had to use my middle finger to pull the trigger. . By the time I reach shore… the next 3-4 hours were th most painfully moments of my life.. I just got out of the hospital in Jamaica.. relaxing at my hotel and my finger is still soar and big! Lesson learned

  4. Angie says:

    I got nailed badly today. Pain was so bad I didn’t know what to do with myself. We’re selling them commercially and getting lots at 16-17 inches. They are SCARY at that size. I soaked in very hot water for about 30 minutes. Then I soaked in ice water to handle the swelling. I also took 3 Aleves and was able to make 2 more dives as the venom deactivated after about an hour.

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