From All Stings Considered, First Aid and Medical Treatment of Hawaiis Marine Injuries
Occurrence in strong onshore winds, into east and north shores during trade wind conditions (majority of time) and onto south and west during infrequent periods of Kona, or south winds.
Oahus estimated 50% box jelly and 50% Portague man-of war, except in Kona weather then majority were box jellyfish. In 1994 lifeguards treated approx 6,500 man-of-war and 8 were major stings needing additional treatment. No deaths have been reported (copyright is 1997) in Hawaii, and 3 deaths in the US. Big # of stings was at Waimanalo, then Bellows, then Kailua other areas no where near the numbers reported. They are surface critters so theoretically not a problem for divers I guess in particular those that look upon ascent just another thing to be looking for up top. Wet suits really help and signs are posted. I know in Kona side (Big Island) the word gets out ASAP, some hotel beaches close with one sighting. Yep, Scuba divers should look up while ascending, surfacing with one arm outstretched to protect their faces.
Small people react more strongly more venom per # body wt.
Initial symptom burning and reddening that subsides after 20 minutes to 1 hour with no treatment. Is usually less painful with shorter duration than that of a box jellyfish. Severe allergic reaction includes confusion, irregular heartbeat, difficulty breathing, elevated or lowered blood pressure and weakness. Delayed reactions can occur weeks later and persist for months usually itch but no pain.
Treatment:
-Pick off visible tentacles with gloved hand, stick etc.
-Rinse with salt or fresh water thoroughly to remove any adhering nematocysts.
-Apply ice for pain.
-Irrigate eye stings with copious amounts of room temperature tap water for 15 minutes. After see physician if blurred vision, continuous tearing, pain, swell or light sensitive.
-Persistent itch, use 1% hydrocortisone 4 X day and Benedryl 1 2 every 6 hrs.
Yup, recent tests revealed vinegar discharged cysts also mixed result from smaller cysts critters. Contradictory testing with meat tenderizer, papain, baking soda and commercial sprays somebody died after papain sprayed yike!. ALCOHOL and URINE caused massive cyst discharge in box jelly (Australian study) and not recommended.
Hawaii Portuguese man-of-war generally resolve with no additional treatment in 15 20 minutes so even harmful therapies may appear to improve symptoms.
