How to Treat a Stingray Sting

Stingrays are cartilaginous fish with flat bodies and one or more venomous spines located on their tails. These creatures inhabit tropical and subtropical waters, which makes them prone to encounters with humans. While stingrays do not typically exhibit aggressive behavior, they may use their spines defensively when stepped on, injecting venom into the wound. However, by following the right procedures, you can properly manage a stingray sting injury.

Stay Calm. While the pain from a stingray sting can be intense and frightening, it is rarely fatal. In fact, most fatalities from stingrays are not caused by venom but by internal injuries (if stung in the chest or abdomen), excessive blood loss, allergic reactions, or secondary infections. These complications can be treated by trained medical personnel.

Recognize the symptoms. Take a moment to identify the symptoms you are experiencing. Common ones include:

• Pain
• Swelling
• Bleeding
• Weakness
• Headaches
• Cramps
• Nausea/Vomiting/Diarrhea
• Dizziness/Lightheadedness
• Rapid heartbeat
• Shortness of breath
• Fainting

Prioritize treating severe symptoms. Medically speaking, some symptoms are more serious than others. Assess whether you’re experiencing an allergic reaction, heavy bleeding, or poisoning. These symptoms should be treated by a healthcare professional immediately.

• Allergic reaction: Swelling of the tongue, lips, face, or other parts of the body; difficulty breathing, rapid or wheezing breath; rash/itching; fainting or confusion.
• Severe bleeding: Dizziness, fainting, or confusion, sweating, rapid heartbeat, low blood pressure, rapid breathing.
• Poisoning: Headache, dizziness, rapid heartbeat, cramps, seizures.

Select the appropriate treatment option. Depending on the severity of the symptoms, you should choose the most suitable medical care method. This could involve self-care, visiting a health station, or calling for an ambulance.

• If you suspect the injury is serious, call emergency services.

Rinse the wound with seawater. While still in the sea, rinse the wound immediately with seawater. Use forceps from your first aid kit (if needed) to remove any stingray barbs or broken pieces from the wound. After the wound is cleaned, go ashore and dry it with a clean towel, ensuring proper care so the injury doesn’t worsen.

• DO NOT remove barbs from the neck, chest, or abdomen yourself.

Stop the bleeding. After being stung by a stingray, bleeding is common. The best way to stop the bleeding is by applying pressure with your fingers on or just above the wound for several minutes. The longer the pressure is applied, the faster the blood will stop flowing.

• If you cannot control the bleeding with direct pressure, you can apply hydrogen peroxide and use pressure to secure the wound. Be aware that hydrogen peroxide may cause some sharp stinging sensation!

Soak the wound in hot water. You can combine this step with applying pressure to stop the bleeding. Soaking the wound in warm water helps soothe the pain by denaturing the venom, which is a protein complex. The water temperature should be around 45°C, but be cautious to avoid burns. Soak the wound for 30 to 90 minutes, or until the pain subsides.

Monitor the wound for signs of infection. Proper wound care includes cleaning with soap and ensuring the wound remains dry. Avoid covering the wound and apply antibiotic ointment daily. Avoid using ointments, creams, or lotions that do not contain antibiotics.

• If the wound becomes red, soft, itchy, painful, or starts swelling or oozing pus after a few days, seek medical attention at the nearest health station or hospital. You may need antibiotics and/or pus drainage.

Perform self-first aid. Depending on your location, first aid kits are usually easy to find. Ask someone to bring you a first aid kit as you begin recognizing symptoms and addressing the wound. The useful first aid tools you’ll need include:

• Gauze
• Wound cleaning solution (hydrogen peroxide, alcohol wipes, soap)
• Forceps
• Pain relievers
• Antibiotic ointment
• Band-aids

Locate the nearest medical station. Medical support is essential to assess and treat the wound properly. You will not only be treated by someone with medical experience but also reduce the risk of infection and other complications. A treatment plan with clear instructions and advice will be provided based on the doctor's examination.

• If the nearest medical station is at least 10 minutes away, you should perform first aid and stop the bleeding before traveling.

Call emergency services. This is the safest option. Dial emergency services when the following situations occur:

• Stabbed or stung in the head, neck, chest, or abdomen.
• No first aid kit or nearby medical station.
• Signs of allergic reactions, excessive blood loss, or venom poisoning.
• Existing medical conditions and/or medications that could affect treatment.
• If you feel uncertain, confused, poisoned, numb, anxious, afraid, or anything else that worries you.

• When swimming, especially in tropical waters, always stay alert. Stingrays, sharks, and other dangerous sea creatures may appear. Also, be mindful of whether others around you need help.
• When entering the water, shuffle your feet to avoid stepping directly on a stingray.
• Try to remove venom from the wound without causing further injury. This will benefit the wound's healing.
• If the sand is hot, you can use it to soak the wound. Afterwards, ensure proper care and cleaning of the wound.
• Take Benadryl immediately as it helps prevent itching and swelling of the wound. You can break an aspirin tablet in half and apply it to the wound.
• If the wound itches, DO NOT scratch or rub it, as this will cause further swelling.
• Urine may help in neutralizing venom.

• Individuals with weakened immune systems, such as those with diabetes or HIV/AIDS, should immediately go to the hospital for proper treatment.
• If in doubt, visit the nearest health station or call emergency services.
• Call emergency services or go to the nearest health station if you experience any of the following signs:
  • Chest tightness
  • Swelling of the face, lips, or mouth
  • Difficulty breathing
  • Widespread itching rash
  • Nausea/Vomiting