Steven P. Hughes
The waters off the coast of Puerto Rico sparkled as Mia prepared to shore dive with her travel companions. They donned their dive gear and kicked out into the calm bay to begin their descent. Grouped as buddy pairs, the divers stayed relatively shallow and enjoyed spotting sea turtles and parrotfish.
Mia was an avid nudibranch enthusiast and loved searching among rocks and overhangs for telltale signs such as gills and rhinophores. She always brought a flashlight to seek out the small, and thus sometimes difficult to spot, slugs. On this dive, however, there was more than a nudibranch hiding under one overhang.
When she extended her flashlight under a rocky projection, Mia felt an intense burst of pain on her right hand. As she cradled her hand to her chest she saw a lionfish swimming away; she knew instantly she had been stung.
Mia’s eyes watered with pain, but she managed to signal her buddy Liam to make an ascent. After being helped to shore by her dive group, Mia lay in the sand while Liam grabbed water and the first-aid kit from the car. As regular divers in the Caribbean, they knew lionfish stings were a possibility and were aware of the treatment steps.
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It’s safe to resume diving after a lionfish sting once the pain is no longer distracting and the wound has healed, preventing infection risk.
Liam flushed her hand with soap and fresh water. Mia’s pain was so powerful that she couldn’t help but cry. She took some ibuprofen but knew it would be a while before she felt its effect. Liam quickly drove her back to their hotel and filled a plastic container with hot water, being careful to ensure a nonscalding temperature.
With her injured hand submerged, over the next hour, Mia’s pain began to ease. Liam refreshed the water regularly to maintain its temperature. Not every sting responds immediately to hot water, but the minor relief allowed Mia to calm down and catch her breath.
After extended hot-water soaking, Mia put a gel antibiotic on the puncture site and wrapped it loosely before applying an ice pack. Moderate pain persisted for the next three hours, but Mia was able to use her hand the next morning and was ready to dive again two days later.
Shutterstock/mc_PongsatornLionfish have 18 venomous spines lining their dorsal, pelvic and anal fins. Stings are painful but are not usually life-threatening to divers.
It’s safe to resume diving after a lionfish sting once the pain is no longer distracting and the wound has healed, preventing infection risk.
Although Mia’s case was relatively simple and she felt better within a few hours, lionfish stings affect each person differently. Pain can range from mild to intense, and there may be redness, swelling and blisters at the site of envenomation. Other symptoms include nausea, vomiting, fever and muscle weakness. Stings are not usually life-threatening, though rare cases of severe infection and tissue damage have been reported.
Avoid lionfish stings by being careful and aware of your surroundings. If you experience a lionfish sting while diving, the most important thing is to remain calm. An uncontrolled ascent is more dangerous than the sting itself. Safely end your dive and manage the pain while a dive buddy reaches out to DAN for professional medical advice.
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Lessons for Life
1 Be prepared. Know if lionfish are present where you dive, and carry a stocked first-aid kit with pain medication and topical antibiotics.
2 Avoid stings. Lionfish often hide in cracks and crevices. Don’t put your hands where you can’t see, and try to be aware of your surroundings and maintain good buoyancy.
3 Treat promptly. Rinse with clean water, immerse in hot (not scalding) water for up to 90 minutes, then clean, apply antibiotic ointment and dress the wound. Take pain relievers as needed and seek medical advice.
