Ignore Everything We Told You Last Week And Do What We Tell You Now. The Advice On Jellyfish Stings Changes Again!

What is the correct first aid treatment for jellyfish stings? Finding this out can be a confusing experience. Just typing “first aid for jellyfish stings” into a web browser throws up a wealth of information, the majority of which is utter bull crap, or at least we thought it was. We were confident, you see, that we knew exactly how to treat a jellyfish sting and having added shaving cream and various condiments to our first aid kit, we were pretty certain that we had covered all the bases and were prepared for anything the gelatinous little buggers could throw at us. What we weren’t expecting however was for everything we thought was right, to be proved wrong, and vice versa. Yet that is exactly what has happened and it’s not just us who’ve got it all wrong. Thanks to the work of some white-coated brainiacs in Hawaii and Ireland, some very authoritative sites including the British National Health Service and Diver Alert Network are going to have to revise their advice too.

The problem is all to do with Portuguese man-of-war. Ah you might say, but a man-of-war is not technically a jellyfish so those brainiacs are barking up the wrong tree all ready. Technically you’d’ be right. A Portuguese man-of-war is a Siphonophore not a jellyfish. However in this instance it makes no difference as Portuguese man-of-war belong to a family called Cnidarians, which include Jellyfish, Hydrae, Anemones and Corals. The tentacles of these Cnidarians contain tiny capsules called Cnidae or nematocysts and it is these toxin-firing structures that cause all the pain and suffering to unwary humans.

The advice that the most authoritative websites give on treating Portuguese man-of-war stings was not to douse the stings with vinegar or alcohol as this made more nematocysts fire and consequently things got worse for the victim. On the other hand, if you knew that the critter that stung you was a notorious Box Jellyfish, then the advice was to drown the affected areas in so much vinegar that the whole place smelt like a Sarsons factory. Confused? Why wouldn’t you be? But things get worse. Some sites suggest that you use baking soda, alcohol, or lemon juice and the myth of urinating on the affected area still persists in places. The British National Health Service (an authoritative organisation, you’d all agree) suggested that the area should be treated with shaving foam and then remaining nematocysts/tentacles scrapped from the skin using a credit card. If shaving foam wasn’t at hand then rinsing with seawater was a good substitute before you got to work with your American Express Card.

Now however Dr Angel Yanagihara of the University of Hawaii and Dr Tom Doyle of the University of Galway, Ireland and their colleagues have put these treatments to the test. Their findings, published in the Journal Toxins, revealed that almost of all the suggested treatments were utter codswallop and the only effective treatment was in fact vinegar. And it doesn’t matter if it’s a sting from a Portuguese man-of-war, a Box Jelly or a Mauve stinger, the best first aid is to rinse with vinegar to remove any residual stingers or bits of tentacle left on the skin and then immerse in 45°C (113°F) hot water or apply a hot pack for 45 minutes.

As for the use of shaving foam, Yanagihara, Doyle et al, found that shaving cream didn’t inhibit the nematocysts from firing and the use of credit card “shaving” produced further firing due to pressure. Doyle himself explained that “this is Quite a u-turn for me” as he helped write the current Irish protocols almost ten years ago, which unfortunately recommend the worst possible combination of steps: seawater rinsing followed by ice pack treatment. "In the coming weeks, I look forward to meeting with members of the Jellyfish Advisory Group to discuss our new findings and how we can revise the current protocols." He said.

Anyone Bring The Chips?

Now before any of you get too clever and start asking silly questions such as what type of vinegar should we use? And is distilled as good as malt? What about white wine vinegar or sherry vinegar or that stuff the French call wine – Beaujolais isn’t it? That’s vinegar most of the time isn’t it?

The simple fact is that vinegar, any sort of vinegar will do. As long as it’s not diluted – which means straight from the bottle chaps. The research also pointed out that use of ice packs should be discontinued and only vinegar followed by heat immersion or the application of hot packs are effective.

Now we know that some of you sharp-eyed types out there might have spotted the name Yanagihara and thought to themselves, “hang on”. “Isn’t that the same Dr Yanagihara founder and principal of Alatalab Solutions, LLC, manufacturer of Sting No More®products”? And you’d be right, she is one in the same. But before you start concocting conspiracy theories about the contents of Sting No More products and the possibility Dr Yanagihara might be the secret owner of a large vinegar manufacturing plant, let us be clear that Yanagihara has already declared a potential conflict of interest as the inventor for USPTO applications PCT/US2012/000095 and PCT/US2015/037974. A.A.Y. and as the founder and principal of Alatalab Solutions, LLC, manufacturer of Sting No More®products. The University stated: management of this disclosed potential conflict of interest was achieved under an approved University of Hawaii Conflict of Interest (COI) plan. All aspects of the COI plan were followed while conducting this research study and in the independent analysis of data. No other member of the group declared a conflict of interest. No. We have no idea what all that means either but we suppose that no one at the University thought there was a problem so why should any of us?

Anyway, Yanagihara et al have already started studying the next stinging jellies on their list. As they've examined two of the three main classes of dangerous stingers, they have their sights set on the last remaining class: true jellyfish (class Schyphozoa). Again collaborating with Doyle, they are working on evidence-based first aid measures for lion's mane (Cyanea capillata), one of largest jellyfish in the world. Which means of course that all this advice might change in the near future. But then there are few things in life you can depend on other than the fact that you are born, you will pay tax and you will die. Oh and that scientists will be adamant about their findings right up to the point they’re contradicted. Until then however we will be revising our advice on our snorkelling hazards page to take account of this research and look forward to revising it again in the near future.

Also Cleans Horse's Hooves

Oh one last thing. The best advice for jellyfish stings is – don’t get stung in the first place. If the area you are snorkelling in is known for jellyfish, wear a full wetsuit including a hood and gloves 

Those of you who’d like to read the full research paper can find it here. 

Is That Shiny New Gadget Really Worth Investing In?

Is This An Investment Opportunity?

In the olden days, if you had invented a new revolutionary device that would allow someone to breathe underwater or even a couscous based beauty product, you only had a few ways of raising the necessary finance to get your shiny new product from the drawing board to the shop shelf. You could ask your friends and family for the money but then you wouldn’t have any friends or family.  You could remortgage your house, sell your kidneys or your children or as a last resort you could sell your soul to a bank and take out a loan. The result of this was that a lot of houses got re-possessed, people were sent to work houses and very few shiny new products ever made it onto those shop shelves. Nowadays though, thanks to the idea of crowdfunding, wannabe entrepreneurs everywhere from Tokyo to Timbuktu have the opportunity to pitch their idea to millions of potential investors around the world. Crowdfunding has been a great success but let’s be honest, for every brilliant idea out there, there are thousands of really, really bad ones. For just as crowdfunding is an opportunity for inventors to showcase their revolutionary new products it also offers the opportunity for the more delusional among us and, of course, the downright dishonest to pry some money out the over trusting and unsuspecting alike. 

Is It An Underwater Gill Or A Motorcycle Handle?

Take for example the case of the Triton Underwater Rebreather. Some time ago this idea appeared on the Iniegogo site. The South Korea designer, Jeabyun Yeon, claimed he was inspired by the breathing apparatus that first appeared in the James Bond film Thunderball and described the concept as a future product that one day, would end the need for complicated SCUBA gear. The device was marketed on the Indiegogo site as:

“A state-of-the-art oxygen respirator, that allows you to breathe underwater up to 45 minutes and at a maximum depth of 15ft by utilising our ‘artificial gills’ technology & liquid oxygen technology. Swim among tropical fish, marvel at exotic coral and experience the serene beauty of marine life without having to come up for air. Welcome to Triton." 

To use the Triton rebreather, swimmers would bite down on a plastic mouthpiece. Two arms, which branch out to the sides of the scuba mask, would then function as efficient gills to deliver oxygen. The scaly texture on the devices arms conceals small holes in the material where water is sucked in. Chambers inside separate the oxygen and release the liquid so that the user could breathe comfortably in the ocean. Using a very small but powerful micro compressor, the concept system would compress oxygen and store it in tanks. The entire gadget is powered by a micro battery, which is around 30 times smaller than a current battery and can charge 1,000 times faster. Wow. That sounds amazing doesn’t it? Of course it does. In fact too amazing to be true. Even those without advanced engineering degrees could quickly recognise that such a product would burn your face off, freeze your lungs and then explode –not necessarily in that order. Whatever it did though, it wouldn’t let you breathe underwater. Now, you might think that even the most gullible investor out there would raise an eyebrow at the description of the device and how it worked. Yet despite the Triton's claims being roundly discredited as a scam, the device was soon all over the media. In seemingly no time at all, the team behind the Triton had raised $900,000 in investment. One Indiegogo user, Hovnimrsk Prdelac, from Marseille France, was so upset with Indiegogos apparent refusal to stop collecting money for the Triton device that he launched his own campaign to raise awareness of the scam. In that campaign he brilliantly dissected the claims made for the Triton and debunked each one before ending his critique with this eviscerating statement: 

“So, we have a designer, a salesman, and a marketing expert who claim they invented a device worthy of four Nobel Prizes (impossible molecular filter extracting dissolved oxygen from water; micro compressor with the power of two trucks; mini battery powering it for 45 minutes, "30 times smaller and 1000 times faster than current batteries"and cheap Dewar flasks surpassing the evaporation rate of thousand-dollar laboratory cryogenic containers by three orders of magnitude), yet they have no engineer, no scientist, no technician, and no expert in cryogenics, chemistry, nanotechnology, or hyperbaric medicine. Amazing results for three young lads with no degree in science, and just some experience with marketing and design!”

Fortunately in May 2016 the people at Indiegogo, having made numerous unsuccessful requests for the Triton team to substantiate their claims, suspended the campaign and refunded all the contributions made (although they have relaunched a new campaign explained in the link). Which was good news for all those investors that, despite the quite obvious flaws in the claims and the fact that a revolution would need to take place in the fields of engineering, materials and molecular chemistry for the Triton to actually work, parted so easily with their cash. 
Obviously the Triton case is an extreme example but scams and dodgy inventions are not the only thing the wannabe investor should be wary of. Sometimes it is not the product that is the problem, but the way it is being marketed. Take for example an idea that has recently caught the attention of snorkellers, freedivers and bubble blowers alike. The device is called Scorkl and has recently appeared on the Kickstarter site. According to the marketing blurb, Scorkl is a self-contained breathing apparatus that offers anyone the chance to breath underwater for up to ten minutes at a time, longer if you buy more than one. Hey you could even buy six or seven and stay under for sixty or seventy minutes and you don’t need a compressor to fill these things up, since you can buy a hand pump that will do it for you. 

Now let’s make it clear that, unlike the Triton, the Scorkl does actually work. The reason we know this, is the fact that it is what is known as a redundant air supply system and looks remarkably similar to SpareAir, which is offered by submersible systems and has been on the market for 25 years. In fact the Scorkl looks so much like SpareAir that trademark and patent infringements are very possible. 

Scorkl then is not a new idea as such; it is in essence a small SCUBA tank fitted with a regulator, which as mentioned above has been on the market in the form of SpareAir for 25 years. What is new is the idea of using a hand pump to fill up the tank and there are some rather big questions on whether that actually works or whether it’s a safe idea at all. There are also some issues surrounding the claims made about the amount of time you can spend underwater using the Scorkl or how deep you can go. According to the Scorkl inventor, David Hallamore, "it's easier to say 'up to 10 minutes' because it's easily understandable, but it's a complex equation and how long you spend underwater on a Scorkl full of air will depend on how fast you are breathing, how big your lungs are, how hard you're working, how cold it is, ... so it might be less than 10 minutes. It might also be more, and maybe a lot more depending on how you use it. The Scorkl, Hallamore explains, contains 3 cu ft when filled to 3,000psi or roughly 60 breaths. The "up to 10 min" calculation works as follows: At 3,000psi the Scorkl holds the equivalent of ~60 breaths. An inhale/exhale cycle of 10/min (1 every 6 seconds) allows for ~6min underwater at 1 atmosphere. A slower cycle of 6/min (1 every 10 seconds) allows for ~10min. 

The problem with this calculation however, is that according to health professionals everywhere, the average person takes 16-20 breaths per minute, more on exertion. That means that at 20 breaths per minute the Scorkl will last just 3 minutes. At 16 breaths per minute it will last an extra 45 seconds and since everyone is already under 1 atmosphere of pressure before entering the water, both of these calculations are based on surface breathing without exertion. So the 10 minutes of air claim only makes sense if the user is a very fit and very experienced diver sitting on a beach or maybe a hibernating tortoise. Then there is the question of the hand pump used to fill the Scorkl. How long do you think it will take an average person, breathing averagely, to pump enough air to fill it to 3000psi?  Well, according to Hallimore, it takes around ten pumps per breath to fill the Scorkl (600 pumps). It gets harder to pump as the pressure in the tank increases but it is manageable for an adult. A steady pumping rhythm of 50/min fills the tank in 12 minutes. Most people will want to rest intermittently though which allows the tank to cool down. Ah! so you might not want to pump too vigorously or persistently just in case the damned thing explodes before you actually pass out from exertion.

Now, despite the Scorkl’s similarity to another product, the questions of how long it will take for an average person to run out of air or whether you’ll suffer a coronary whilst trying to refill the bloody thing, the real problem is none of these. The real problem is that the Scorkl is seemingly being marketed at snorkellers, swimmers, boating enthusiasts and everyone in between. The problem with that is that no matter if you fill the Scorkl with a hand pump or a compressor, it will contain compressed air and if you are not aware of the dangers of using compressed gas underwater there is a good chance your lungs will go pop.

If you’re a bubble blower please bear with us, if you’re not a bubble blower please pay attention because here comes the science bit. Boyle's law explains why changes in depth while in shallow water can be more hazardous than equivalent changes of depth in deep water. In essence, British physicist/chemist Robert Boyle discovered that at a constant temperature and mass, the volume of a gas is inversely proportional to the pressure exerted on that gas. When the pressure is doubled, the volume is reduced to one-half of the original volume. Conversely, when the pressure is reduced by one-half, the volume doubles. While exposed to atmospheric pressures at sea level, our lungs are in a state of equilibrium as we inhale and exhale. Slight pressure changes occur as we change elevation, yet equalisation of the pressures inside and outside the lung is a passive and inconspicuous event with each breath. During descent into water, all gas-containing spaces in the body tend to shrink as the pressure surrounding the body increases; for example, the lung volume of a breathhold diver becomes smaller with the descent in the water column. Because scuba regulators deliver breathing gas at the ambient pressure of the diver, a higher concentration of the breathing gas enters the lungs, preventing the reduction in volume that would otherwise occur.

If the diver does not exhale during ascent, the lungs will progressively increase in volume until the elastic limit of the alveoli is exceeded and lung injury occurs. This forces gas into one of three locations: 1) the space within the chest cavity (pleural space), a condition known as pneumothorax; 2) the tissue planes within the lung itself (interstitial space), from where it may travel into the space around the heart, the tissues of the neck and the larynx (mediastinal emphysema); or 3) the blood. In this latter condition (arterial gas embolism, or AGE), gas bubbles can then pass from the pulmonary capillaries via the pulmonary veins to the left side of the heart and then to the carotid or basilar arteries (causing cerebral arterial gas embolism, or CAGE).

It is important to note that a breathhold ascent after inhaling from a scuba tank from a depth as shallow as 4 feet (fsw) may be sufficient to tear alveolar sacs, causing lung injury and one of these three disorders mentioned above.

In short, it is a very good possibility that hordes of Scorkl users, unaware of the dangers of holding your breath on ascent are going to turn up in hospitals around the world with frothy red goo jetting out of their noses. Consequently there will be bad publicity, recriminations and the inevitable lawsuits. Which is not exactly the sort of investment most people are looking for, particularly if the company is already facing legal action for patent infringement and the myriad injuries caused by overheating tanks exploding on beaches everywhere. David Hallimore obviously recognises the dangers of lung expansion injury as he points out that the “misuse of the Scorkl can be dangerous. Whilst decompression sickness isn't much of a risk because of the depth and time restrictions of such a small cylinder, pulmonary damage (chest expansion injuries) is nevertheless a risk if a user holds their breath during ascent or ascends too quickly
Non-scuba trained users should not use the Scorkl below 3m depth or more than five times in one day. Staying above 3m dramatically reduces this risk of pulmonary damage (although does not eliminate it entirely). Each purchaser will be provided with an information kit informing them of this (and other) risks and strategies to avoid them, even within the 3m limit (for example, not holding one's breath and/or exhaling during ascent, not ascending too quickly)
Scuba-trained users will be able to use the Scorkl below 3m at their discretion but they too will be warned of the same risks”

Well, you might say! That’s all right then. People are going to be informed of the risk. After all what sort of person would misuse a Scorkl anyway or ignore a warning? To which we would reply, perhaps the sort of person who doesn’t read or even ignores information kits. After all, people have been warned of the dangers of smoking for decades and yet people still smoke. And then there are the sorts of people who invest nearly a million dollars in a device that was, and still is, even less genuine than an Estate Agents smile. There is a solution of course and that is not to sell the Scorkl to non-SCUBA trained people but we suspect that is not what the company is going for. So any investors out there might want to think very carefully about the safety implications of such a device being available to everyone, everywhere, before handing over their money.

So what have we learned? Well what we’ve learned at the DSC is that a fool and his money is easily parted and that if we were going to put our money into a crowdfunding project we’d take a long look at what the idea is, whether it is feasible or plausible and not likely to explode in ours or anyone else’s face for that matter. And, if it sounds too good to be true it probably is. If you didn’t already know this then we’re happy to impart our advice. If you did know, we’re sorry to have wasted your time and suggest you get back to your beer, Cheers!