Just as you were enjoying your swim in the beautiful sea, you noticed a sting on your foot. The pain gets worse. When you get out of the water you see a red rash on the painful area. What do you do know?

As a medical centre near the beach, BIMC gets plenty of marine envenomation cases. Many marine creatures are venomous, and beachgoers experience envenomation regularly. Some common creatures are:

· Sea urchins. They have globe-shaped bodies covered with spines found all over the world. Because they are not aggressive, human contact with sea urchins is accidental or intentional. Swimmers step on them in shallow surf. Shell gatherers and tourists commonly pick them up unaware that they must handle the spines carefully to avoid injury.

· Jellyfishes. These are free-swimming, bell-shaped, gelatinous creatures with tentacles that may be more than 3 feet in length. They are found near the surface of the water during times of diminished light. Harmful jellyfish have stingers (nematocysts) capable of piercing the skin.

· Other creatures with nematocysts include Portuguese man-of-war, sea wasps, anemones, and fire corals. These organs function long after the animal is dead.

The most common cases that come to BIMC are jellyfish and sea urchin envenomations.

So if you noticed sudden pain and/or rash on your body after swimming in the sea, here’s what you should do:

· Get out of the water. If possible, try to see and identify the creature near you, this can be an important info for the treatment. Notify someone else that you had a marine creature sting. This is important in case you develop severe allergic reaction, so this person can help you.

· Look at the painful area.

o If it seems like a puncture type of wound, flush the wound with sea water.

o If it doesn’t look like a puncture type wound, the best is to flush it with vinegar to neutralize the toxins. Do not use fresh water on jellyfish envenomation, it will increase the pain.

o If you’re not sure just flush it with sea water.

· If you bring a tweezer in your first aid kit, you may attempt to remove any tentacles or spines. But if it is near the joint, leave it.

· Immobilize the extremity.

· Seek medical attention.

Things not to do

· Do not touch the affected area with your bare hands, the remaining stingers can pierce your hand.

· Do not rub the rash, because it might spread the toxin from any existing stinger.

· Do not urinate on the wound or apply oil or gasoline on the wound. There is no benefits in these myths, instead might cause more irritation on the skin.

· Do not apply ice on the affected area.

Don’t worry about the wound and seek medical attention ASAP if you notice these conditions :

Nausea and vomiting, fainting or unconsciousness, difficulty breathing, and delirium are present in severe cases

Spines that penetrate at or near a joint, this usually requires surgical removal.

How to avoid marine envenomation

· Ask the locals at beaches or waters which you are not familiar.

· Do not handle any unknown animals, including sponges, coral, sea worms, jellyfish, sea urchins, and spiny starfish.

· Be cautious when you can’t see the bottom. Shuffling may scare of some animals before you step on it.

· Some animals would come out on certain times. Jellyfishes usually would be found at sunrise or sunset time.