Nothing's
more fun than a day at the beach-unless you or
your child has a close encounter with a stinging
jellyfish, Portuguese man-of-war, sea urchin or
coral.
Though
most plentiful in warm climates, jellyfish and
their cousin, the Portuguese man-of-war, are common
to just about every North American beach area.
They drift along on top of the water with their
tentacles trailing, ready for the unwary swimmer.
But these creatures and any broken-off tentacles
can still sting when they're just lying around
on the beach or floating in the water, even after
a couple of days.
Sea
urchins don't actually bite or sting, but they
have spines that can puncture the skin and release
venom. And while coral may look like exquisite
rock, it's really a fragile colony of tiny creatures
that can cause a painful wound if a child happens
to step on it or scrape a leg against it.
It's
best that all these injuries be seen by a physician.
But here's what you can do before you reach the
doctor.
Jellyfish
and Portuguese Man-of-War
Get
to dry land. ''If the child is stung in water,
take him out of the water,'' says Kenneth W. Kizer,
M.D., M.P.H., professor of emergency medicine
and medical toxicology at the University of California,
Davis, School of Medicine and a specialist in
wilderness medicine. Depending on how much venom
is released, a sting can be quite serious. Because
the child may panic or even lose consciousness,
it's crucial to get him out of the water.
Reach
for your credit card. Jellyfish and Portuguese
man-of-war tentacles have tiny parts that resemble
miniature harpoons. When these venom-filled ''harpoons,''
called nematocysts, puncture the skin, the result
is painful. You want to get the tentacles and
nematocysts off as quickly as possible, says Glenn
G. Soppe, M.D., a physician in San Diego, California,
who lectures on aquatic bites and stings. MEDICAL
ALERT
When to See the Doctor
Jellyfish
and man-of-war stings may cause pain, cramps,
nausea and tingling as well as a hivelike rash,
says Kenneth W. Kizer, M.D., M.P.H., professor
of emergency medicine and medical toxicology at
the University of California, Davis, School of
Medicine and wilderness medicine specialist.
For
these stings, it's imperative to seek medical
attention if the child complains of tightness
in the throat or if he experiences shortness of
breath or difficulty breathing. Children with
any underlying health problems, such as diabetes,
arthritis, and/or immune problems should be taken
to the nearest medical center immediately, says
Dr. Kizer.
Coral
injuries can lead to infection: ''The problem
with coral is that it's sharp, jagged and fragile,''
says Dr. Kizer. ''Little pieces of coral tend
to break off in the wound, making it very prone
to infection. And some of the coral secretions
can be toxic.'' These wounds demand special attention
by a doctor who is familiar with coral injuries,
according to Dr. Kizer.
Puncture
wounds from sea urchins, stingrays and any spiny
fish should also be treated by a doctor as soon
as possible, although you should immerse the wound
in hot water (110° to 115°F) immediately
to relieve pain.
Although you can't see the nematocysts, you can
scrape them off with a credit card, says Dr. Kizer.
Just brush the edge of the card across the sting
area. ''If possible, wear surgical gloves while
you're doing this,'' says Dr. Kizer. You want
to be sure you don't get stung, too.''
Rinse
with saltwater. ''Use only saltwater to rinse
the wound,'' says Dr. Kizer. Fresh water can actually
cause the little ''harpoon cells'' to fire off
and inject more venom, he cautions. Don't rub
the skin and never rub it with sand because this
will cause the nematocysts to fire off more venom.
Neutralize
them. You also want to neutralize the nematocysts
so they don't inject any more venom. The best
neutralizer is vinegar, but you can also use a
slurry of baking soda and water or a mixture of
rubbing alcohol and meat tenderizer blended into
a liquid paste, says Dr. Kizer.
''In
Hawaii, where I used to practice, we used alcohol
mixed with meat tenderizer all the time,'' he
says. ''The alcohol keeps the nematocysts from
firing, and the meat tenderizer breaks down the
venom.'' He recommends that you mix just enough
alcohol to the meat tenderizer to make a thin
paste, like ketchup. Apply this paste to the wound
and leave it there until the pain goes away, usually
anywhere from 5 to 30 minutes. ( Because some
children's skin may be sensitive to ingredients
in meat tenderizer, it's best to monitor your
child to see if irritation or an allergic reaction
occurs.)
Use
painkillers. ''Because many of these injuries
cause inflammation, over-the-counter products
such as acetaminophen [Children's Tylenol] can
be helpful,'' says Dr. Kizer. Check the package
directions for the correct dosage for your child's
age and weight. If your child is under age two,
consult a physician.
Give
a jellyfish lesson. ''The best treatment for jellyfish
stings is prevention,'' says Dr. Kizer. Point
out jellyfish lying on the beach and warn your
child not to touch them. ''Jellyfish can remain
venomous for at least a day or two after they've
washed up on the beach,'' he points out.
Coral
and Sea Urchins
Remove
spines with tape. If your child steps on coral,
you can remove the fine, hard-to-get pieces by
applying a piece of adhesive tape to the abrasion
site and then removing it, says Constance L. Rosson,
M.D., of the Good Samaritan Hospital in Portland,
Oregon. When you pull the tape off, you pull up
the tiny spines. Then bathe the area with vinegar,
suggests Dr. Rosson.
Clean
it out. If the wound is bleeding, apply pressure
for a few minutes to stop the bleeding. Then use
saltwater or fresh water to clean out the wound.
''Remove any obvious foreign material,'' says
Dr. Kizer. ''And remember that these kinds of
injuries are at very high risk for infection,''
he says.
Get
into hot water. The toxins released by sea urchins
can be broken down by heat. For these wounds,
soak the body part in hot water, around 110°
to 115°F, 30 to 90 minutes, says Dr. Kizer.
That's warmer than body temperature, but not hot
enough to scald. ( This treatment also works for
other stinging fish such as scorpion fish, lionfish
and catfish.)
Raise
the limb. Swelling may occur with both coral and
sea urchin wounds. Elevate the area, if possible,
to discourage swelling, says Dr. Kizer.
Check
tetanus records. ''The bacteria that cause tetanus
live in the ocean, and this may be a problem for
coral and spine puncture wounds,'' says Dr. Kizer.
After the child's first shots, she should get
them every ten years, plus a booster if she has
a nasty injury and the last shot was more than
five years ago, he says.
Prepare
with protection. To help your child avoid sea
urchin stings, point out tide pools or rocky areas
where these creatures are often found, suggests
Dr. Kizer. He recommends reef shoes or aquatic
shoes with hard, spine-proof soles and mesh tops
for any child who's walking or swimming in a beach
area that has sea urchins or coral.
