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There is an anti-venom treatment for only one species of box jellyfish, Chironex fleckeri. Treatment for stings from all box jellyfish species starts with a complete flushing of the area by a mild acidic solution such as vinegar, or citric acid. This inhibits the unfired nematocysts from further envenoming the victim. All remaining tentacles should then be removed by picking, scraping, or flushing them off the skin with salt water. Do not press on the tentacles, nor rub them off with sand. Immediate medical assistance should be sought, since box jelly envenomation may be life threatening.

If not a box jelly sting, or if stung swimming in an area not typical for box jellies, do not use vinegar. Also, do not use urine, alcohol, meat tenderizer, acidic solutions, baking powder, or even fresh water. All of these have been demonstrated to trigger further envenomation in certain jellyfish species. Start treatment by flushing with sea water while removing all remaining pieces of tentacle. Once the area is free of tentacles, heat can help break down the venom proteins, so soak the affected area in hot water, or under a hot shower for 20 minutes. Fresh water is fine at this point if all remaining pieces of tentacle have been removed. The water should be as hot as possible (without scalding, of course). If heat is not available, an ice pack can reduce the pain, but it only offers temporary relief.

Again, please do not listen to old wives tales about urine, alcohol, and other home remedies; science has proven them to be less than worthless treatments. In short, flush box jelly stings with vinegar if available and call medics. Otherwise, flush with sea water and remove any remaining pieces of tentacle. Treat with heat, and ice is nice.

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