Field Guide to Venomous and Medically Important Invertebrates ...

Field treatment can include dousing the affected site with vinegar because it has been suggested
that it may inactivate any undischarged nematocysts that may be present. However, the benefits
of this old remedy may be of little value. Similarly, the application of a compression bandage
and limb immobilization is recommended by life savers and ambulance officers, but there is no
evidence that it modifies the subsequent clinical course. Appropriate pain suppressants should
be administered while transporting the victim to hospital. Treatment is mainly supportive and
intravenous narcotics normally are required to alleviate pain. Some patients respond better to
morphine and opiate infusions which may have to be given several times before the pain
subsides. In the most serious cases, a condition known as the sympathomimetic syndrome may
develop that generally is characterized by a broad suite of symptoms including delusions,
paranoia, rapid or slow heartbeat, irregular heartbeat, high or low blood pressure, high fever,
sweating, bristling of hairs, dilated pupils, overactive physiological responses, and seizures. This
condition is extremely dangerous for the patient and emergency medical care should be provided
at earliest opportunity. Severe cases may require ventilatory support with continuous positive
airway pressure or tracheal intubation.
The Indo-Pacific jellyfish, Chiropsalmus quadrigatus, has been implicated in many serious
stinging attacks and caused at least one death, although little specific information is available for
this species. This species also is commonly known as the box jellyfish, but it should not be
confused with Chironex fleckeri. It is assigned the common name of false box jellyfish here to
avoid confusion.