Category Archives: Diving Medicine, Health & Safety

Recovering From A Massive Heart Attack

I apologize for being away for so long. I got extremely busy with teaching first aid & CPR classes and have been working long hours 7 days a week trying to get all the classes completed so I have not had an opportunity to dive in months now.

Apparently I worked a little too hard and it finally caught up to me. On September 10th I suffered a massive heart attack also known as a STEMI (ST-elevation myocardial infarction) while loading our CPR training equipment for classes the next day.

Since I did not have the typical symptoms it went unrecognized for about 7 to 8 hours before I finally recognized one of the common symptoms, profuse sweating. I then added up the other minor “unrelated” symptoms that I had been having all day and knew immediately what was happening.

It was a very hot day and the humidity was unusually high. We had just received a new cargo van from the dealership and I was preparing it for the next days classes by loading 10 sets of CPR manikins, 5 dog CPR manikins, airway training manikins, oxygen tanks, and other training equipment into it.

Somewhere around noon I noticed that the temperature inside the back of the van had reached 125 degrees while I was working inside it, so when I started feeling slightly nauseous I assumed it was from the heat and that I was getting dehydrated. When I stopped to cool off in the shade the nausea would stop, but when I started working again in the heat it came back.

This continued for several hours and then I noticed a slight tingling in the fingers of both hands. Since this was not a familiar symptom I continued to work getting the  equipment loaded and organized in the van.

About 7:00 in the evening I started noticing that my chest was getting a little tight. I had asthma as a child and it felt as though I was having a very mild asthma attack due to the humidity. Actually an extremely mild case, one that I would not even need to use an inhaler to treat. Since the symptoms were so mild and I was almost finished with getting the van ready I continued to work.

A few minutes later I noticed a pain in the middle of my back right between my shoulder blades that felt just like I had to stretch and pop my back. Since I had been doing a lot of lifting and bending all day I had expected some back discomfort, so it was not a shock to me. I tried unsuccessfully for several minutes to relieve the pain by stretching and shrugging my shoulders to get my back to pop, but the pain just would not go away.

Then the one symptom that I recognized started. It had started to cool off outside but all of the sudden I began to sweat profusely. Almost at once my clothes were dripping with sweat. It was almost like I was standing inside a shower.

I immediately recognized this fatal symptom as a heart attack and immediately reached for the first aid kit to retrieve the 81 mg chewable aspirin that was kept inside. I chewed two of them quickly and let them dissolve in my mouth and under my tongue as I teach in the first aid classes. I also grabbed an oxygen training kit and placed myself on high-flow oxygen (15 liters /min) with a non-rebreather mask. I then called 911 for an ambulance.

When the ambulance arrived I was hooked up to an EKG to monitor the electrical activity of my heart and the Paramedics immediately recognized a significant elevation of the S and T waves on the monitor signifying a STEMI heart attack with complete blockage of at least one of the arteries supplying the blood flow to the heart causing significant damage to the heart. A normal heart attack does not show any change to the EKG however a STEMI heart attack affects a very large portion of the heart and will affect an EKG reading.

Instead of staying on-scene to stabilize me as they normally would have I was immediately rushed to the emergency department for treatment. Blood tests were performed to measure the amount of damage to the heart by looking for chemical markers in the blood.

Troponin is a protein found on the blood that relates to contraction of the heart muscle. Its level in the bloodstream are used to detect heart muscle damage. Troponin levels are normally between 0.0 and 0.10 µg/mL. On my first test the result was .98 µg/mL which showed that a massive heart attack had occurred and that extensive heart muscle damage had resulted from it.

I was rushed into the cardiac catheterization laboratory to evaluate the status of my heart, arteries and the amount of heart damage. They found that my heart had about 50% productivity right now, which means that I was only able to pump half the amount of blood that I should be pumping.

One of the arteries was completely blocked so an angioplasty was performed where they basically run a wire with a balloon on the end of it from your groin up inside your arteries until they come to your heart where the blockage is at. Then the balloon is inflated to breakup the blockage in the artery. A stent was placed in the artery to prevent it from collapsing.

The cardiologist performing the procedure also noted that a second artery had a 90% blockage in it, and a third had a 50% blockage in it. Unfortunately since one artery was completely blocked and this was an emergency procedure they could not risk performing an angioplasty on the other two arteries and I would have to come back after I healed to have them done and have two more stents put in those arteries. I was kept in the hospital for observation and had to wear an EKG transmitter so they could monitor me all the time.

On Friday the 13th I was finally released from the hospital and was glad to get back home. I had classes scheduled all week that I needed to get ready for, the first of which was the next morning when I had a class of 7 students for CPR certification. Wanting to take it easy after the heart attack I had the students carry the equipment in for the class so I did not have to exert myself, however during the class I did have some minor chest pain with sweating which was quickly relieved by placing a nitroglycerin tablet under my tongue.

The next week went about the same, a couple very minor incidents of chest pain on exertion relieved with nitroglycerin. On Friday I had a 1-on-1 class to teach and had to park farther away from the building than I would have liked (about a block). I walked to the apartment building pulling the CPR manikins behind in their wheeled case.

Upon reaching the apartment and starting the class I began to feel chest pain, felt nauseous and started sweating profusely once again. I placed a nitroglycerin tablet under my tongue and the symptoms were relieved, but came back in a few minutes so I took another one. When the symptoms started coming back again I postponed the class and called for an ambulance. Back to the hospital that I had only escaped from one week before.

3 nitroglycerin tablets later and after receiving high-flow oxygen again the symptoms left just about the time the ambulance was getting me to the hospital. After 6 hours in the Emergency Department I was sent to the Telemetry floor to wear the portable EKG transmitter once again.

The Emergency Department doctors were stumped because my Troponin levels did not rise from 0.2 like they expected which would signify another heart attack. They stated that I could take 6 to 8 hours for the levels to increase in the blood, so I would be admitted so that could continue testing me. I agreed to stay for them to run 3 more tests to verify if the Troponin levels were increasing or not. If they increased I would stay in the hospital, if they did not I would sign myself out AMA (Against Medical Advice) and go back home.

At 1:00 in the morning the results finally came back from the third test, my Troponin levels were still at 0.2 and showed no indication of any further damage to my heart. Since the Troponin levels did not rise, they could not classify this episode as a heart attack because there was no evidence of a heart attack. Since there was no indication of further damage to the heart and I already had a followup appointment scheduled for Monday with the cardiologist I kept my word and signed myself out of the hospital against their advice. I could not see any benefit of staying cooped up in the hospital all weekend when by the test results, clearly I did not have another heart attack.

It will be awhile before I am able to dive again, and I will have to limit my activities to boat dives as shore dives will be too demanding and exhausting for me, at least for now.

Shark Incidents On The Rise In Hawaii

Courtesy of Division of Aquatic Resources, Hawaii Department of Land and Natural Resources

This graphic depicts only confirmed unprovoked incidents, defined by the International Shark Attack File as “incidents where an attack on a live human by a shark occurs in its natural habitat without human provocation of the shark. Incidents involving…shark-inflicted scavenge damage to already dead humans (most often drowning victims), attacks on boats, and provoked incidents occurring in or out of the water are not considered unprovoked attacks.”

As you can clearly see from the graphic above shark incidents are clearly on the rise in Hawaiian waters on recent years, but an unprecedented 10 non-fatal shark incidents occurred in 2012 alone, more than any previous year in over three decades. 2013 started off with 3 incidents before the end of February and two of them occurring at different locations off the island of Maui on February 21st at 6:00pm.

Courtesy of Division of Aquatic Resources, Hawaii Department of Land and Natural Resources

It is not known exactly what is causing the sudden increase in shark incidents in Hawaii. Even though incidents of sharks biting people are rising they are still relatively low, averaging only 3 to 4 per year.

One factor may include changes in the weather due to seasonal changes. As you can see from the chart at the right, more incidents occur between October and December than any other time of the year.

Courtesy of Division of Aquatic Resources, Hawaii Department of Land and Natural Resources

Our activities in the water may also be a factor. Certain water activities have a higher than average number of shark incidents, like surfing and swimming as this chart shows.

One theory is that many sharks “hunt” from underneath and attack prey at the surface of the water like seals. With swimmers and surfers on the surface of the water, this makes them prime candidates for this type of hunting behavior.

But what about scuba diving? Does scuba diving lead to higher or lower shark incidents? Are diver vs. shark incidents more fatal?

Courtesy of Shark Attack File, Florida Museum of Natural History, University of Florida

According to the International Shark Attack File – a compilation of all known shark attacks that is administered by the American Elasmobranch Society and the Florida Museum of Natural History, approximately 20% of shark attacks on divers are fatalities.

This is a surprisingly high percentage when comparing it to other water activities, however the number of shark attacks on divers is extremely low compared to other water activities. One reason that more of the incidents result in fatalities could be that they happen when the diver is under water which could have lead to drowning. The diver vs. shark incident reports and statistics do not state how many of the divers died as a result of drowning because diver drowning is not asked on the ISAF reports being filed.

So, with all of this information, what can we do to make ourselves safer when diving? The Hawaii Department of Land and Natural Resources offers the following Shark Safety Tips:

  1. Swim, surf or dive with other people, and don’t move too far away from assistance.
  2. Stay out of the water at dawn, dusk and night, when some species of sharks may move inshore to feed.
  3. Do not enter the water if you have open wounds or are bleeding in any way. Sharks can detect blood and body fluids in extremely small concentrations.
  4. Avoid murky waters, harbor entrances and areas near stream mouths (especially after heavy rains), channels or steep drop-offs. These types of waters are known to be frequented by sharks.
  5. Do not wear high-contrast clothing or shiny jewelry. Sharks see contrast very well.
  6. Refrain from excessive splashing; keep pets, which swim erratically, out of the water. Sharks are known to be attracted to such activity.
  7. Do not enter the water if sharks are known to be present. Leave the water quickly and calmly if one is sighted. Do not provoke or harass a shark, even a small one.
  8. If fish or turtles start to behave erratically, leave the water. Avoid swimming near dolphins, as they are prey for some large sharks.
  9. Remove speared fish from the water or tow them a safe distance behind you. Do not swim near people fishing or spear fishing. Stay away from dead animals in the water.
  10. Swim or surf at beaches patrolled by lifeguards and follow their advice.

Remember, shark incidents involving scuba divers are extremely low. If you look at worldwide averages, of the average of 5 fatalities worldwide that happen each year, only 1 in those 5 worldwide would have been a diver (20%).

Now lets put that into some perspective. According to the National Safety Council, in 2000 alone in the United States 46,749 people died in “Transport Accidents”.

Looking at those kinds of numbers, I think I am a lot safer in the water with the sharks.

Scuba Diving Safety Tips

Fotografía hecha en Playa del Carmen, México, ...

(Photo credit: Wikipedia)

Whether you are a seasoned diver or you are just learning how to dive, there’s a lot to learn and remember when it comes to diving. I am going to go over some handy tips that will help to keep you safe on your next dive.

  1. Get Certified – First and foremost, NEVER scuba dive unless you have been properly trained and are certified as a scuba diver by a recognized scuba training agency. Such training will make you aware of the more common problems you will face underwater, and how to reduce the likelihood of these problems occurring.
  2. Get A Checkup – Some medical conditions are not compatible with safe diving, while other conditions may allow you to dive safely with caution. Only a physician knowledgeable with scuba diving will be able to properly advise you as to your medical situation regarding scuba diving. Scuba diving requires a lot of strenuous physical activity and can be demanding on the body. A dive physical can help you identify any problems that you may not have even known about beforehand. Studies have shown that about ¼ to ⅓ of all scuba diving fatalities are from heart and/or circulatory problems.
  3. Relax – Being relaxed and comfortable underwater is key to a successful dive. If something happens:
    1. Stop
    2. Breathe
    3. Think
    4. Act

    The worst thing that you could do is to panic, it could make a manageable situation unmanageable very quickly.

  4. Never Hold Your Breath – Never holding your breath while scuba diving is the cardinal rule of diving. Always breathe as normally as possible to avoid the potential of lung over-expansion injuries. Delaying exhaling while ascending can cause damage to the alveoli in your lungs, and can therefore cause severe lung injury, and in extreme cases, death. Also remember to exchange carbon dioxide for good clean air by breathing deeply and slowly.
  5. Have Good Buoyancy and Secure Gear – Be sure your buoyancy skills are well honed before you go diving in any fragile environments. Coral takes hundreds of years to form and thrive, only growing about one inch each decade. Fragile sea fans and corals can be destroyed with the kick of a fin. Please make sure your feet are up and that you are always aware of your surroundings and your own placement in the water. Clip gauges, spare regulators, and other dangling equipment to your BC or secure it in pockets, so that you help save the environment and also to keep you from becoming entangled in fishing line or other objects underwater.
  6. Be Conservative – Dive tables or computer limits do not necessarily constitute a boundary between “bends” or “no-bends” and cannot guarantee that you will not suffer from Decompression Illness. The diving decisions you make should be based upon current suggested safety guidelines for diving and your own unique circumstances while diving.
  7. Keep to the limits — Stay well within the guidelines of the table or computer you’re using, and allow an appropriate surface interval between dives.
  8. Be Flexible – Be prepared to modify your dive plan for unanticipated factors such as exertion, cold or depth and personal physiological factors affected by your activities before, during and after diving.
  9. Be Prepared to Dive — Make sure you’re rested, healthy, well hydrated and well-nourished prior to your diving activities.
  10. Avoid Alcohol – Never drink alcohol before or between dives. Along with the inebriating effects that alcohol can cause including slowing down reaction times, it can also make the body dehydrated which can cause serious problems while diving.
  11. Equalize — Begin equalizing before your head submerges and continue to equalize frequently during descent.
  12. Descend feet first — This slows your descent some and makes it easier to equalize your ears.
  13. Ascend slowly — Always ascend at the rate of 30 feet / 9.1 meters per minute or slower.
  14. Make a safety stop — for three to five minutes at 10-15 feet / 3-4.5 meters on all dives.

Stingray Sting Treatment

Hawaiian Stingray

Hawaiian Stingray

A distant cousin of the shark, Stingrays and other rays like skates, electric rays, guitarfishes and sawfishes are classified as Batoidea, a type of cartilaginous fish and have around 500 species in thirteen families.

They are pretty widespread and can be found in seas on the floor, across the world in both temperate and cold-water. The manta is an exception living in open waters and a few fresh water species living in brackish bays and estuaries.

Most species of rays have flat bodies that facilitate them to effectively conceal themselves in their environment which is the sea bed. Their disc like shape (in most ray species) have five ventral slot-like body openings called gill slits that lead from the gills and their mouths on the undersides. Because their eyes are on top of their bodies they cannot see their prey and use smell and electro-receptors similar to those of sharks.

There are nine known species of rays found in Hawaiian waters, divided into three distinct categories, Manta, Eagle, and Stingray. The most common stingray in Hawaii is the broad stingray, sometimes referred to as the Hawaiian, brown or whip-tail stingray pictured above.

The Hawaiian stingray has a diamond-shaped body similar to the diamond stingray. The Hawaiian stingray can grow to over 5 feet wide, but few of this size are rarely seen any more. Their tails are twice as long as their body length and are equipped with venomous spines similar to a serrated-edged knife which it uses for defense.

The most common injury from a stingray comes from accidentally stepping on one which will cause its tail to whip around and being driven into the victims leg or foot.

To avoid being stung by a stingray, use care when wading in sandy-bottomed shallow water. A good preventive measure is to do the “stingray shuffle.” Slowly slide or shuffle your feet in the sand. Any stingrays in the area are likely to retreat as fast as possible.

To treat a Stingray sting follow these simple steps:

  1. Immediately wash the area with fresh water.
  2. DO NOT remove any visible spines from the wound, leave this for trained medical personnel as the spines are barbed and may cause more damage to flesh when being removed.
  3. Use direct pressure with gauze pads to control bleeding.
  4. Soak the affected area in warm water (110°F to 113°F) for 30 to 90 minutes to denature the toxins.
  5. Administration of analgesia (never use aspirin in conjunction with hot water treatments).
  6. Watch for signs of systemic symptoms and be ready to perform CPR if necessary or treatment for anaphylactic shock.
  7. Transport to the hospital for evaluation and wound debridement and care.

Devil Scorpionfish Sting Treatment

DevilScorpionfish

Devil Scorpionfish

In the Hawaiian language, scorpionfish are known as nohu, which is the same name used for stonefish in Tahiti.

A close relative of and often mistaken for the stonefish, the Devil Scorpionfish pictured to the right was photographed at Sharks Cove on Oahu’s North Shore.

There are approximately 350 known species of scorpionfish around the world, approximately 25 of which can be found in Hawaii waters. Lionfish and turkeyfish are also in the scorpionfish family, but generally have longer fins.

Like the stonefish, the Devil Scorpionfish is also a master of disguise in both body shape, and coloration. It is very often mistaken for a common rock. Most stings occur when someone mistakingly steps on a Devil Scorpionfish in shallow water near the shore, where there oftentimes are a lot of other rocks, or along the reef. The Devil Scorpionfish is able to blend in with the other rocks and stay motionless, thereby virtually disappearing from view.

If a person is stung, that person will experience intense throbbing, sharp pain. There may be severe bleeding and a whitened color of the area around the site of the sting and the color of the area changes as the amount of oxygen supplying the area decreases. The victim may experience intense abdominal pain, nausea, vomiting, and diarrhea, delirium, fainting, fever, headache, muscle twitching, seizures, paralysis. difficulty breathing, changes in blood pressure, heart failure, pulmonary edema, and loss of consciousness.

Immediate emergency medical treatment is advised as some people are more susceptible to the venom than others. The sting of the stonefish can be extremely deadly.

To treat a Stonefish sting follow these simple steps:

  1. Immediately wash the area with fresh water.
  2. Carefully remove any visible spines from the wound.
  3. Use direct pressure with gauze pads to control bleeding.
  4. Soak the affected area in warm water (110°F to 113°F) for 30 to 90 minutes to denature the toxins.
  5. Administration of analgesia (never use aspirin in conjunction with hot water treatments).
  6. Watch for signs of systemic symptoms and be ready to perform CPR if necessary or treatment for anaphylactic shock.
  7. Transport to the hospital for evaluation and wound debridement and care, and anti-venom administration where available.

Recovery usually takes about 24 – 48 hours but can take several months.

Stonefish Sting Treatment

Stonefish

Stonefish

Although the stonefish is not found in Hawaiian waters, I thought it was necessary to include it because divers travel, and I want you to be prepared incase you ever encounter one of these nasty looking creatures while diving in the Indo-Pacific region where the stonefish calls home.

The stonefish is a master of disguise in both body shape, and coloration. It is very often mistaken for a common rock, which is why it is so dangerous.

Most stonefish stings occur when someone mistakingly steps on a stonefish in shallow water near the shore, where there oftentimes are a lot of other rocks. The stonefish is able to blend in with the other rocks and stay motionless, thereby virtually disappearing from view.

If a person is stung, that person will experience intense throbbing, sharp pain. There may be severe bleeding and a whitened color of the area around the site of the sting and the color of the area changes as the amount of oxygen supplying the area decreases. The victim may experience intense abdominal pain, nausea, vomiting, and diarrhea, delirium, fainting, fever, headache, muscle twitching, seizures, paralysis. difficulty breathing, changes in blood pressure, heart failure, pulmonary edema, and loss of consciousness.

Immediate emergency medical treatment is advised as some people are more susceptible to the venom than others. The sting of the stonefish can be extremely deadly.

To treat a Stonefish sting follow these simple steps:

  1. Immediately wash the area with fresh water.
  2. Carefully remove any visible spines from the wound.
  3. Use direct pressure with gauze pads to control bleeding.
  4. Soak the affected area in warm water (110°F to 113°F) for 30 to 90 minutes to denature the toxins.
  5. Administration of analgesia (never use aspirin in conjunction with hot water treatments).
  6. Watch for signs of systemic symptoms and be ready to perform CPR if necessary or treatment for anaphylactic shock.
  7. Transport to the hospital for evaluation and wound debridement and care, and anti-venom administration where available.

Recovery usually takes about 24 – 48 hours but can take several months.

Lionfish Sting Treatment

Lionfish

Lionfish

The beautiful and graceful lionfish has fins with venomous tips that are a danger to anyone in the water where a lionfish happens to be.

The venomous dorsal spines of the lionfish are used for defense and when threatened the lionfish may turn to an upside down position to bear the spines.

Lionfish are considered to be an invasive species that devour juvenile indigenous reef fish species and crustaceans and have the potential to throw off the local ecosystem.

The lionfish is one of the most venomous fish in the ocean, ranking second only to stingrays in the number of human stings worldwide with an estimated 40,000 to 50,000 cases annually.

If a person is stung, that person will experience intense throbbing, sharp pain, tingling sensations, sweatiness and blistering. In worst case scenarios the symptoms may include headache, nausea, abdominal pain, delirium, seizures, paralysis of limbs, changes in blood pressure, breathing difficulties, heart failure and tremors, pulmonary edema, and loss of consciousness.

A common treatment is soaking the afflicted area in hot water, as there is currently no anti-venom. However, immediate emergency medical treatment is still advised as some people are more susceptible to the venom than others.

To treat a Lionfish sting follow these simple steps:

  1. Carefully remove any visible spines from the wound.
  2. Use direct pressure with gauze pads to control bleeding.
  3. Soak the affected area in warm water (110°F to 113°F) for 30 minutes to denature the toxins.
  4. Administration of analgesia (never use aspirin in conjunction with hot water treatments).
  5. Watch for signs of systemic symptoms and be ready to perform CPR if necessary or treatment for anaphylactic shock.
  6. Transport to the hospital for evaluation and wound debridement and care, and anti-venom administration where available.

 

Benched From Diving – Update

This is an update to an earlier post. Click here to read the original post.

It has now been two full weeks since the infection started and my ear still will not equalize so I went back to the doctor today to have my ear checked again.

Apparently the Augmentin (Amoxicillin/clavulanic acid) antibiotics and the antibiotic ear drops that the doctor put me on two weeks ago did not clear up the infection in my ear. The infection in my ear canal has cleared up, but the infection in my middle and inner ear seems to be antibiotic-resistant. There is also fluid still being retained behind the membrane (ear drum), which they say may take weeks to dry up.

This is the second ear infection that I have had so far this year. Because of my past issues with ear infections, and my eustachian tubes being so tiny, they are referring me to an Ear, Nose & Throat specialist to have it checked. They also want to send me for a hearing test on that ear.

They are still worried about the possibility of there being a tiny hole in the membrane, but I don’t think there is because it is not draining fluid. It seems as if there were a hole there that it would drain and relieve the pressure behind it.

I will have to wait for the ENT specialist to call me to set up the appointments to find out what exactly is going on in there. So in the meantime they have put me on stronger intravenous antibiotics and I now have a portable pump that I wear in a shoulder pouch for the next ten days.

I hate getting IV’s. When I get my really bad migraines I have to get them for pain medication and hydration, now I have to wear one 24-hours a day for the next week and a half. This really sucks. I will see how it goes, you know they say that medics and doctors are the worst possible patients.

It’s been two full weeks since I have been able to dive, and it looks like it will be at least another two weeks before I can even begin to think about it again. My gills are going to dry up!

Portuguese Man O’ War Sting Treatment

Portuguese man-of-war (Physalia physalis)

Portuguese man-of-war (Physalia physalis) (Photo credit: Wikipedia)

The Portuguese Man O’ War is often mistaken for a jellyfish however it is completely different, and the treatment for its extremely painful stings is also different than for that of a jellyfish. In fact, if it were treated in the same way as a jellyfish sting, it would actually make the situation worse.

The portuguese man o’ war can be found along the Windward beaches while the islands are receiving trade winds, and along Leeward beaches while the islands are receiving “Kona Winds”.

The man o’ war is a pelagic colonial hydroid, meaning that it is not a single animal, but a colony or group of four different highly specialized organisms (polyps). These polyps are interdependent on one another for survival.

The body of the man o’ war consists of a gas-filled bladder that contains a high level of methane gas, along with trace amounts of nitrogen, oxygen, and carbon dioxide. It is translucent and tinted either shades of pink, blue, or purple. The body grows between 3 to 12 inches long and may extend above the water by as much as 6 inches. This bladder has a crest on top of it that is used as a sail so that the wind can push the man o’ war across the ocean like a tiny sail boat.

Beneath the gas-filled body hang clusters of polyps containing tentacles which may reach up to over 100 feet in length when stretched out. These polyps are of three specialized types, each having a specific function. The function of the dactylozooid polyps’ is detecting and capturing prey, gonozooid polyps’ function is reproduction, and gastrozooid polyps’ function is breaking down the captured prey for food.

Each of the polyps cannot survive on their own, and the man o’ war cannot survive missing one of the polyp organisms. Their only chance for survival is their bond with each other.

Tentacles of the dactylozooid’s contain tiny nematocystic (coiled thread-like) structures that can paralyze small fish and other prey that come into contact with them. The gastrozooid’s then cover the prey and start digesting it. The man o’ war will eat basically anything that comes into contact with their stinging tentacles. As the man o’ war drifts across the surface of the ocean carried by the wind its tentacles are constantly search through the water underneath it for food.

Muscles in each tentacle contract and drag prey into range of the digestive polyps, the gastrozooids, which, acting like small mouths, consume and digest the food by phagocytosis – by secreting a full range of enzymes that variously break down proteins, carbohydrates and fats. The prey consists mostly of small crustaceans, small fish, algae and other members of the surface plankton which the man-of-war ensnares in its entangling, stinging nematocystic threads.

The sting of the man o’ war is extremely painful to humans and can cause very serious effects including fever, shock, and interference with pulmonary and respiratory functions. Where ever its blue tentacles have touched bare skin a red whip-like wavy welts which are very painful. These welts can last for many hours and can reappear up to 4 or 6 weeks after the incident due to the release of histamine, bradykinin, kallikrein or acetylcholine resulting in bleeding within the skin from capillary and venous vasodilation and occasional leukocyte infiltration.

To treat a Portuguese Man O’ War sting follow these simple steps:

  1. Immediately flush the affected area with fresh water to remove any unfired nematocysts from the skin. Contrary to what is taught in folklore, local practice, and even some papers on sting treatment, DO NOT use vinegar, urine, ammonia,meat tenderizer, sodium bicarbonate, boric acid, lemon juice, fresh water, steroid cream, alcohol, cold packs, papaya, hydrogen peroxide, or anything else other than water to flush the affected area as it may cause the remaining nematocysts to fire injecting more toxin and could also lead to infection. There is absolutely no scientific evidence to suggest that any of these home remedies will disable further stinging and venom discharge.
  2. Using a gloved hand, stick, or other such tool, pick off any remaining pieces of tentacle from the skin.
  3. Immediately flush the affected area with fresh water once again.
  4. Once the area has been flushed clean with water, apply ice packs to the affected area to relieve the pain.
  5. Immediate medical attention may be necessary as the stings may induce anaphylactic shock.

Beach Safety eBook

eBookCoverWith summer finally upon us, many families will be heading out to the beach more often.

Before you head out to the beach, download this complimentary Beach Safety eBook from Oahu CPR Training.

It contains valuable safety tips to help keep your families safe at the beach this summer.

BeachSafetyEbook

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