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Hot water immersion v icepacks for treating the pain of Chironex fleckeri stings: a randomised controlled trial.

Abstract To investigate the effectiveness of hot water immersion for relieving the pain of major box jellyfish (Chironex fleckeri) stings.Design, interventions: Open label, randomised controlled trial comparing the effects of hot water immersion (45°C) and icepacks.Setting, participants: 42 patients with suspected C. fleckeri stings treated in the emergency department of the Royal Darwin Hospital during September 2005 - October 2008.
PMID
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Authors

Mayor MeshTerms

Cubozoa

Ice

Immersion

Keywords
Journal Title the medical journal of australia
Publication Year Start




PMID- 28359008
OWN - NLM
STAT- MEDLINE
DA  - 20170330
DCOM- 20170412
LR  - 20170412
IS  - 1326-5377 (Electronic)
IS  - 0025-729X (Linking)
VI  - 206
IP  - 6
DP  - 2017 Apr 03
TI  - Hot water immersion v icepacks for treating the pain of Chironex fleckeri stings:
      a randomised controlled trial.
PG  - 258-261
AB  - OBJECTIVE: To investigate the effectiveness of hot water immersion for relieving 
      the pain of major box jellyfish (Chironex fleckeri) stings.Design, interventions:
      Open label, randomised controlled trial comparing the effects of hot water
      immersion (45 degrees C) and icepacks.Setting, participants: 42 patients with
      suspected C. fleckeri stings treated in the emergency department of the Royal
      Darwin Hospital during September 2005 - October 2008. MAIN OUTCOME MEASURES: The 
      primary outcome was pain severity, assessed with a visual analogue scale (VAS).
      Secondary outcomes included crossover to the alternative treatment, use of opioid
      analgesia, emergency department length of stay (LOS), and delayed urticaria.
      RESULTS: Of 42 patients (26 males; median age, 19 years; IQR, 13-27 years), 25
      were allocated to icepack treatment and 17 to hot water immersion. The
      demographic and baseline VAS data for the two groups were similar. After 30
      minutes of treatment, 11 patients (65%) treated with hot water and 14 (56%)
      treated with icepacks had clinically improved pain scores (absolute difference,
      9%; 95% CI, -22% to 39%; P = 0.75). One patient treated with icepacks crossed
      over to heat immersion. Two patients in each arm received intravenous opioid
      analgesia. Median emergency department LOS was 1.6 h (IQR, 1.0-1.8 h) for icepack
      patients and 2.1 h (IQR, 1.6-2.8 h) for heat immersion patients (P = 0.07). Five 
      of seven patients who were followed up developed delayed urticaria. CONCLUSION:
      Hot water immersion was no more effective than icepacks for reducing the acute
      pain of box jellyfish stings, but increased emergency department LOS by about 30 
      minutes. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry,
      ACTRN12605000007639.
FAU - Isbister, Geoffrey K
AU  - Isbister GK
AD  - University of Newcastle, Newcastle, NSW [email protected]
FAU - Palmer, Didier J
AU  - Palmer DJ
AD  - Royal Darwin Hospital, Darwin, NT.
FAU - Weir, Rebecca L
AU  - Weir RL
AD  - Royal Darwin Hospital, Darwin, NT.
FAU - Currie, Bart J
AU  - Currie BJ
AD  - Menzies School of Health, Royal Darwin Hospital, Darwin, NT.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
PL  - Australia
TA  - Med J Aust
JT  - The Medical journal of Australia
JID - 0400714
RN  - 0 (Analgesics, Opioid)
RN  - 0 (Ice)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Analgesics, Opioid/therapeutic use
MH  - Animals
MH  - Bites and Stings/complications/*therapy
MH  - *Cubozoa
MH  - Female
MH  - Hot Temperature/*therapeutic use
MH  - Humans
MH  - *Ice
MH  - *Immersion
MH  - Male
MH  - Pain/etiology
MH  - Pain Management/methods
MH  - Pain Measurement
MH  - Treatment Outcome
MH  - Urticaria/etiology
MH  - Young Adult
EDAT- 2017/03/31 06:00
MHDA- 2017/04/13 06:00
CRDT- 2017/03/31 06:00
PHST- 2016/08/22 [received]
PHST- 2016/10/17 [accepted]
AID - 10.5694/mja16.00990 [pii]
PST - ppublish
SO  - Med J Aust. 2017 Apr 3;206(6):258-261.

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