How to Administer First Aid for Lionfish Puncture Wounds

By DAN Boater

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What are the symptoms and side effects of a lionfish sting?

Lionfish punctures, which are commonly referred to as lionfish "stings", can be extremely painful and lead to the rapid development of localized edema and subcutaneous bleeding. Pain can last for several hours, edema typically resolves in two to three days, and tissue discoloration can last up to four or five days. Due to edema and the venom’s inherent toxicity, puncture wounds on fingers can lead to ischemia and necrosis.

How do you treat a lionfish sting?

1. Rinse the wound with clean fresh water.
2. Remove any obvious foreign material, including any spines.
3. Control bleeding if needed.
   Tip: It is OK to allow small punctures to bleed for a minute immediately after being stung; this may decrease the venom load.
4. Apply heat to manage pain. Immerse the affected area in hot water (upper limit of 113°F/45°C) for 30 to 90 minutes. Repeat if necessary.
   Tip: If you are assisting a sting victim, first test the water on yourself to assess tolerable heat levels. Do not rely on the victim’s assessment, as intense pain may impair his or her ability to evaluate tolerable heat levels. If you cannot measure water temperature, a good guide is to use the hottest water you can tolerate without scalding. Note that different body areas have different heat tolerances, so test the water on yourself on the same area where the victim was injured.
   Tip: If hot water is not available, apply a cold pack or ice in a dry plastic bag.
   Tip: Thermolysis can also be a secondary benefit worth pursuing, but it tends to be less effective in cases in which the venom has been injected deep into the tissues.
5. Bandage the wound(s) as needed. Cover the site with a clean absorbent pad or dressing. Secure it with a sterile bandage big enough to cover the pad, extending past the edge.
6. Seek a professional medical evaluation.

How do you avoid lionfish stings?

Although lionfish are not aggressive, it's always a good idea to maintain a prudent distance. If you engage in spearfishing or culling activities, avoid improvisations, and do not try to handle these animals until you learn from people who are more experienced.

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It is intended for general informational purposes only and does not address individual circumstances. It is not a substitute for professional medical or dental advice, diagnosis or treatment and should not be relied on to make decisions about your health. Never ignore professional medical or dental advice in seeking treatment because of something you have read on the DAN Boater website. If you think you may have a medical emergency, immediately call your doctor, dial 911, or contact emergency services nearest you.