1. Envenomation (bluebottle)

2. Blue Bottle Jellyfish
In Australia and New Zealand, this jellyfish is known as the blue bottle, due to its colour and shape when strewn on a beach.

3. Blue Bottle Jellyfish
Elsewhere in the world it is known as the "Portuguese Man o War" as it is said to look like a Portuguese battleship with a sail
Its scientific name is Physalia utriculus

4. Is it a Jellyfish?
No, Blue Bottles differ from true jellyfishes in several ways.
The gas-filled float supports a number of specialised tentacles, which are actually members of a complicated colony.
The individual members, cooperate to form what looks to us like one animal-a jellyfish

5. Zooids These individual members are called zooids.
Each zooid has a specific role and together they function as if it were one animal.
For example a number of zooids will make up the stinging tentacles, others will make up the feeding tentacles and some are the reproductive members of the colony

6. The floats the gas float itself is a modified colony member.
The floats are of two sorts-ones that face left and others that are angled toward the right.
This means that the same wind will push the two variations in different directions, avoiding all the colonies becoming washed up on the beach and dying.

7. Feeding
The blue bottle feeds on small fish and other small ocean creatures.
They envelope their prey with their tentacles, where a poison is released thus paralysing its prey before being consumed

9. Tentacles The tentacles adhere extremely well to their prey.
If a tentacle is put under the microscope you will see that it looks like a long string of barbed hooks, which explains the ability of the tentacle to attach.
If a tentacle attaches itself to a human, it releases a poison (through the use of nematocysts), and if you continue to rub the skin after the tentacle has been removed more poison or venom will be released.

10. Fatalities
No fatalities have ever been reported within Australia or New Zealand from the sting of a blue bottle.

11. Beware!
At the mercy of the wind, they are sometimes blown into shallow waters, and often wash up onto the beach.
Beach-goers should beware as these animals can deliver a painful sting to the unwary swimmer, or even when dead on the beach
Bluebottles are the most common cause of jellyfish stings in Australia.
They vary in size, and the severity of the sting is usually dependent on the amount of contact the skin has had with the tentacle

13. Signs & Symptoms
A bluebottle sting usually causes an immediate and severe pain, which generally fades over about an hour.
You can usually see where on the body the sting has occurred because it leaves a red line where the tentacle has been.
Sometimes this line has a ‘beaded’ appearance, and is swollen and itchy.
Occasionally blisters can develop at the site of the sting, and very rarely the sting may cause scarring.

15. Treatment (non tropical)
Washing the site of the sting with vinegar is NOT recommended for bluebottle stings occurring in non tropical waters.
This change was introduce in July 2007

16. Treatment (non tropical)
It is now recommended that the area where the bluebottle sting has occurred be immersed in hot water.
Recent studies have shown that this use of hot water is more effective than the previous advice to use ice packs and cold water at reducing the pain of bluebottle stings.

17. Management

18. Post treatment
If after treatment there is continuing pain, itchiness or blistering at the site of the sting, it would be best to advise the casualty to visit a doctor
The doctor might prescribe a topical treatment such as a cortisone cream to reduce the inflammatory reaction

19. Important
Although extremely unlikely, it is possible that a bluebottle sting could trigger an anaphylactic reaction (a severe allergic reaction that can be life-threatening).
If a person who has been stung by a bluebottle develops distressing chest tightness or difficulty breathing that is getting worse and you suspect anaphylaxis, treat as per the management of anaphylaxis and call 000

20. Treatment (tropical waters)
This only applies if you are in the tropics (e.g. North Queensland):
If the bluebottle or any unknown jellyfish is found in tropical waters, then the treatment in the first instance would be to flood the stung area with vinegar.

21. Coffs Harbour Divisional Training
Questions
20 September 2018
Coffs Harbour Divisional Training

22. Scenario 5.1
You are on duty at a music festival being held beside the foreshore in non‐tropical waters on a warm summers’ day. People attending the festival have also been enjoying a swim in the sea. You are on patrol relatively close to your post with two other members when you are alerted by a teenage girl calling out from the waters edge. As you approach the casualty, she complains of pain in her leg. You observe oval‐shaped blanched wheals on her leg with redness. Demonstrate how you manage this casualty.

23. History
You are at a music festival near a non‐tropical beach. You have been for a swim and now walking along the waters edge when you feel some brush against your leg in the water. You are experiencing severe local pain in the area of the sting and call out for help to some St John first aid volunteers you see on patrol. There are oval‐shaped wheals on your leg with redness.

24. St John Management

25. 5.1 Checklist Check for danger What are the possible dangers?
Assist the casualty from the waters
Pick off any adherent tentacles with fingers or tweezers
Rinse the stung area well with seawater to remove invisible stinging cells
Assisted casualty to the first aid post or sent one member to obtain a bucket of hot water (coffee vendor??)

26. 5.1 Checklist
Test the hot water to ensure the casualty is comfortable with the temperature
Immerse the stung leg in the hot water
Ask the casualty if the pain is relieved by hot water (the pain is still persisting)
Apply a cold pack to relieve the pain
Complete an Casualty Report (OB12)
Advise the casualty that if pain persists to consult a doctor