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Niżnik Ł, Jabłońska K, Orczyk M, Orzechowska M, Jasińska J, Smoliniec B, Hućko A, Kosowicz P, Klocek A, Słoma P, Roztoczyńska A, Toporowska-Kaźmierak J, Jurowski K. Hot-Water Immersion (HWI) or Ice-Pack Treatment (IPT) as First Aid for Human Envenomation by Marine Animals? Review of Literature. Toxins (Basel) 2024; 16:273. [PMID: 38922167 PMCID: PMC11209160 DOI: 10.3390/toxins16060273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2024] [Revised: 06/11/2024] [Accepted: 06/13/2024] [Indexed: 06/27/2024] Open
Abstract
Envenomation by marine animals poses a significant health concern globally, affecting both local residents and tourists in coastal regions. The primary objective of this review is to critically evaluate the existing scientific literature to determine the most effective first-aid treatment for envenomations caused by marine animals, specifically whether hot-water immersion (HWI) or ice-pack treatment (IPT) provides the best immediate care. This comprehensive review covers a wide range of marine envenomations, from jellyfish stings to stingray injuries. While our focus is primarily on the efficacy of HWI and IPT, we also explore the role of cold-water treatment as a result of its relevance and similarity to ice-pack applications. In addition, we examine other treatments mentioned in the literature, such as medications or vinegar, and highlight their findings where applicable. To provide a clear and structured overview, we summarised the articles in separate tables. These tables categorise the type of research conducted, the marine species studied, the region of origin of the marine species, and the key findings of each study. Our analysis of the available evidence indicates a general consensus in the scientific community on the effectiveness of HWI or IPT for envenomation by marine animals. However, when treating those injuries, it is crucial to consider all factors since there is no universally superior treatment due to the diverse nature of marine habitats.
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Affiliation(s)
- Łukasz Niżnik
- Department of Regulatory and Forensic Toxicology, Institute of Medical Expertise, Łódź, ul. Aleksandrowska 67/93, 91-205 Łódź, Poland
- Toxicological Science Club ‘Paracelsus’, Institute of Medical Sciences, Medical College, Rzeszów University, Al. mjr. W. Kopisto 2a, 35-959 Rzeszow, Poland (A.K.)
| | - Karolina Jabłońska
- Toxicological Science Club ‘Paracelsus’, Institute of Medical Sciences, Medical College, Rzeszów University, Al. mjr. W. Kopisto 2a, 35-959 Rzeszow, Poland (A.K.)
| | - Michał Orczyk
- Toxicological Science Club ‘Paracelsus’, Institute of Medical Sciences, Medical College, Rzeszów University, Al. mjr. W. Kopisto 2a, 35-959 Rzeszow, Poland (A.K.)
| | - Martyna Orzechowska
- Toxicological Science Club ‘Paracelsus’, Institute of Medical Sciences, Medical College, Rzeszów University, Al. mjr. W. Kopisto 2a, 35-959 Rzeszow, Poland (A.K.)
| | - Judyta Jasińska
- Toxicological Science Club ‘Paracelsus’, Institute of Medical Sciences, Medical College, Rzeszów University, Al. mjr. W. Kopisto 2a, 35-959 Rzeszow, Poland (A.K.)
| | - Barbara Smoliniec
- Toxicological Science Club ‘Paracelsus’, Institute of Medical Sciences, Medical College, Rzeszów University, Al. mjr. W. Kopisto 2a, 35-959 Rzeszow, Poland (A.K.)
| | - Agnieszka Hućko
- Toxicological Science Club ‘Paracelsus’, Institute of Medical Sciences, Medical College, Rzeszów University, Al. mjr. W. Kopisto 2a, 35-959 Rzeszow, Poland (A.K.)
| | - Piotr Kosowicz
- Toxicological Science Club ‘Paracelsus’, Institute of Medical Sciences, Medical College, Rzeszów University, Al. mjr. W. Kopisto 2a, 35-959 Rzeszow, Poland (A.K.)
| | - Anna Klocek
- Toxicological Science Club ‘Paracelsus’, Institute of Medical Sciences, Medical College, Rzeszów University, Al. mjr. W. Kopisto 2a, 35-959 Rzeszow, Poland (A.K.)
| | - Paweł Słoma
- Toxicological Science Club ‘Paracelsus’, Institute of Medical Sciences, Medical College, Rzeszów University, Al. mjr. W. Kopisto 2a, 35-959 Rzeszow, Poland (A.K.)
| | - Aleksandra Roztoczyńska
- Toxicological Science Club ‘Paracelsus’, Institute of Medical Sciences, Medical College, Rzeszów University, Al. mjr. W. Kopisto 2a, 35-959 Rzeszow, Poland (A.K.)
| | - Joanna Toporowska-Kaźmierak
- Toxicological Science Club ‘Paracelsus’, Institute of Medical Sciences, Medical College, Rzeszów University, Al. mjr. W. Kopisto 2a, 35-959 Rzeszow, Poland (A.K.)
| | - Kamil Jurowski
- Department of Regulatory and Forensic Toxicology, Institute of Medical Expertise, Łódź, ul. Aleksandrowska 67/93, 91-205 Łódź, Poland
- Laboratory of Innovative Toxicological Research and Analyses, Institute of Medical Sciences, Medical College, Rzeszów University, Al. mjr. W. Kopisto 2a, 35-959 Rzeszow, Poland
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Wilcox CL, Yanagihara AA. Heated Debates: Hot-Water Immersion or Ice Packs as First Aid for Cnidarian Envenomations? Toxins (Basel) 2016; 8:97. [PMID: 27043628 PMCID: PMC4848624 DOI: 10.3390/toxins8040097] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 03/26/2016] [Accepted: 03/29/2016] [Indexed: 01/22/2023] Open
Abstract
Cnidarian envenomations are an important public health problem, responsible for more deaths than shark attacks annually. For this reason, optimization of first-aid care is essential. According to the published literature, cnidarian venoms and toxins are heat labile at temperatures safe for human application, which supports the use of hot-water immersion of the sting area(s). However, ice packs are often recommended and used by emergency personnel. After conducting a systematic review of the evidence for the use of heat or ice in the treatment of cnidarian envenomations, we conclude that the majority of studies to date support the use of hot-water immersion for pain relief and improved health outcomes.
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Affiliation(s)
- Christie L Wilcox
- Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A. Burns School of Medicine, University of Hawai'i at Mānoa, Honolulu, HI 96822, USA.
| | - Angel A Yanagihara
- Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A. Burns School of Medicine, University of Hawai'i at Mānoa, Honolulu, HI 96822, USA.
- Békésy Laboratory of Neurobiology, Pacific Biosciences Research Center, School of Ocean and Earth Science and Technology, University of Hawai'i at Mānoa, Honolulu, HI 96822, USA.
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Lakkis NA, Maalouf GJ, Mahmassani DM. Jellyfish Stings: A Practical Approach. Wilderness Environ Med 2015; 26:422-9. [PMID: 25935311 DOI: 10.1016/j.wem.2015.01.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Revised: 12/18/2014] [Accepted: 01/06/2015] [Indexed: 02/06/2023]
Abstract
Jellyfish have a worldwide distribution. Their stings can cause different reactions, ranging from cutaneous, localized, and self-limited to serious systemic or fatal ones, depending on the envenoming species. Several first aid treatments are used to manage such stings but few have evidence behind their use. This review of the literature describes and discusses the different related first aid and treatment recommendations, ending with a summarized practical approach. Further randomized controlled trials in this field are needed.
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Affiliation(s)
- Najla A Lakkis
- Department of Family Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Grace J Maalouf
- Department of Family Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
| | - Dina M Mahmassani
- Department of Family Medicine, American University of Beirut Medical Center, Beirut, Lebanon
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