Stings from other types of jellyfish in Phuket waters are also common, although rarely serious. In all cases of jellyfish stings, including those of the box jellyfish, you should apply vinegar as soon as possible, to stop the activation of undischarged nematocysts, and thus neutralise the sting. Often confused with jellyfish stings are those from sea lice, which are also prevalent in our waters. These bites are like multiple pin pricks, often uncomfortable and to some, quite painful. It’s usually the case that swimmers don’t know what they’ve been bitten by, they’re only aware that they’ve developed a sudden localised rash or redness. If this happens, taking an antihistamine often reduces the rash, and a painkiller such as Paracetamol can lessen the pain. If these remedies don’t work, and you’re worried, consult a doctor.

Stings from stone fish, which are frequently described as the world’s most dangerous, are therefore serious. There are many stone fish in Phuket’s waters. They’ve got spines on the back which spring up when the fish is disturbed, and the sting they inflict is extremely painful. Rapid swelling, muscle weakness, paralysis and shock may follow. The first aid action for stone fish stings is to immerse the affected area in hot water, as soon as possible. The water should be as hot as the person can handle, but not so hot that it scalds. Frequently, hospitalisation for intravenous narcotic analgesia is required. As a responder, you should be aware that a victim might collapse suddenly, and that CPR may be required.

As the name would suggest the stingray can cause problems, and they too are common here. They aren’t normally aggressive but they lie on the sea floor camouflaged in their background. The injury usually occurs when a swimmer or diver accidentally steps on one. The spine, located near the tail, contains venom, and this whips up, commonly piercing the ankle or foot of the unwary person, who may only be wading in shallow water. The stinger can also break off in the wound, and must be removed. As for stone fish injuries, immerse the area in hot water, and control any bleeding by direct pressure. Most stingray injuries need to be seen by a doctor, as they tend to become infected. It’s also important to ensure that all remains of the spine are removed, sometimes under microscopic surgery.

The lion fish has venomous fin spines that can produce painful puncture wounds. When stung, the victim experiences immediate pain followed by rapid swelling of the affected area. Stings can also cause nausea, breathing difficulties, paralysis, convulsions and collapse. Death may occur, although this is very rare in otherwise healthy people. Treatment, again, is to remove the spines and place the affected area in hot water. An x-ray is usually required to ensure that all spines have been removed.

Cone fish, which are quite attractive are regularly picked up or handled by unsuspecting divers. They have a barb which can inject a venomous toxin. The resulting symptoms include intense pain, numbness and tingling. In severe cases, muscle paralysis, including cessation of breathing may occur, leading to death. As above, immerse the area in hot water and apply a pressure immobilisation bandage. CPR may also be necessary, so responders should be prepared to resuscitate.

There are lots more bites and stings that cause problems, from the divers who have lost fingers courtesy of a moray eel, to the hundreds who get spiked by a sea urchins each year.

Having said all this, if a little caution is exercised, most people who enter the water will have no problems. Know what you’re picking up. Just because it looks nice doesn’t mean it isn’t dangerous. When walking in shallow water or wading, keep an eye out for stingrays, or better still, shuffle your feet forward rather than taking steps. Know how to treat various bites and stings and ensure you always carry vinegar when you’re going to the beach. Also, don’t believe in mythical treatments such as rubbing sand on jellyfish or other marine bites. Research has proved this doesn’t work. It just makes the situation worse.

Because of the nature of marine bites and coral cuts, such injuries can take a long time to heal, sometimes many months. Secondary infections are not uncommon, as are problems caused by the failure to completely remove any barbs or stings from a wound. Ulcers can form, and many repeat visits to the hospital may be needed to clear infected sites. If you’re stung, scraped or pierced, and serious symptoms present, seek medical advice as soon as possible.

Peter Davison is the Manager International Services at Phuket International Hospital.
Tel: +66 (0)76 249400, Email: info@phuketinternationalhospital.com