11 Recommendations for Treating a Lionfish Sting

11 Recommendations for Treating a Lionfish Sting

Hunting Invasive Lionfish

Many theories exist on how the lionfish invasion began. Some think they were transported from their native waters via ballast tanks on large cargo vessels. Others say they were likely released by aquarium owners who no longer wanted to care for them. And the most common, hurricane Andrew. In 1992, hurricane Andrew devastated South Florida damaging a large commercial aquarium, possibly releasing six-eight lionfish into Florida’s Biscayne Bay. This theory was actually debunked by the very scientist that first reported the escape. Walter Courtenay, a fisheries biologist and professor emeritus at Florida Atlantic University in Boca Raton, says he would like to “put this idea to rest.” Walter was the one who suggested a link between Andrew and the lionfish in 1995 in the Newsletter of the Introduced Fish Section, a publication of the American Fisheries Society. “It was second-hand information,” says Courtenay, “which unfortunately” continues to spread, so that hurricane Andrew is often mentioned as the reason for the catastrophic lionfish invasion. In an article published by the American Association of Advancement of Science, Courtenay said that several days after the 1992 hurricane, Courtenay’s informant told him about “six to eight lionfish” had been spotted alive in Florida’s Biscayne Bay. They were thought to have escaped after Andrew smashed their large aquarium, which sat on a seawall at the edge of the bay. Courtenay published the report because he wanted people to keep an eye out for the lionfish and to track their spread if they successfully established a breeding population. But he never received a report about any additional sightings. He now thinks it unlikely that this event (if it happened) led to the current invasion.

Regardless of how this invasion was started, one fact remains. Lion fish are here to stay. With the ability to produce up to 30,000 eggs every 4 days, extripating the spiny invader is simply impossible. One of major issues is that there are very few natural predators taking the fish. Unwilling to stand by and watch the lionfish over run the delicate coral reefs, divers all throughout the Atlantic and Caribbean have taken up spears in order to reduce the impact on popular dive sites.

Hunting lionfish, while not an ideal way to deal with such a prolific invader, is the best option at the moment. This method is dangerous and requires specialized training. Since lionfish can be found from 1-1000 feet underwater, capturing them on Scuba is the most efficient way of removing the fish from the reef. Whether above or below water, handling lionfish can be extremely dangerous.  Their spines are very sharp, and even worse, venomous! Lionfish have two glandular grooves along the dorsal, ventral and anal spines. The glandular tissue extends about ¾ the distance from the base of the spine towards the tip. The glandular grooves contain a colorless glandular tissue, and they are covered by a sheath of tissue. This sheath is pushed down as the spine enters the victim and the glandular tissue is disrupted, releasing the venom. The venom is composed of acetylcholine and a neurotoxin which causes severe pain, swelling and rash in humans.

Tim Codling, avid diver and lionfish culler was recently stung while removing a lion fish from the cobalt blue waters of Grand Cayman. In an effort to help others, Tim generously shared his notes.  His injury nearly cost him his left index finger. Listed below are his personal recommendations for dealing with a sting. While these recommendations can be used anywhere, the doctor and hospital information is specific to the Cayman Islands.  Please note, some might find the images below disturbing.


1. Remain calm. Notify your dive buddy and immediately terminate your dive.


2. Moment of lion fish sting, a diver can immediately start trying to squeeze or “milk”

the venom out of stung area. This has helped other divers lessen the amount or distance of 

the venom spread. The diver can do this while signaling the other divers and while ascending.


3. Ascend slowly, observing all decompression stops, and surface as soon as possible.


4. Remove any foreign material such as spines. Add pressure to the wound to try and 

squeeze out the venom. Rinse the wound with clean water.  


5. Soak wound (30 minutes) in heated, non-scalding, water as soon as possible. 

The lion fish venom is protein based and is neutralized by the hot water thus preventing

the protein from moving into the blood stream. The hot water is quite effective for controlling the pain.


6. Call 911 as soon as possible. The operators have all been instructed and are familiar with

medical protocol. They will immediately initiate preliminary assessment and treatment. As soon

as possible, contact marine injury specialists, Dr. Osterloh or Dr. Robertson at the Cayman 

Clinic (949-7400) who will coordinate the medical procedures necessary for a lion fish envenomation.

As most injuries occur to the hands and if there is significant tissue damage, a referral will likely be made to Dr.Tanja Ebanks, a hand specialist, at CTM Hospital (946-0067). 


7. If not close to medical care, one could take BENADRYL (Antihistamine) and IBUPROFEN (Motrin or Advil). (Anti inflammatory). Medication will not only reduce the pain but more importantly reduce the swelling that can pressure the arteries, veins, and lymph ducts shut cutting off the bodies vital healing process to the area of the sting. The more swelling that occurs, the greater the wound and skin in the area suffers, turning grey as the swelling persists. The immediate care can dramatically reduce the damage to the affected area.


8. Monitor vitals, circulation, airway, and breathing. People commonly go into shock.  


9. Your 911 operator will direct you to the appropriate medical facility. Get there as soon as possible.


10. No lion fish envenomation should ever be underestimated. Pain can be significant and secondary

complications much more so. Get them treated to avoid any complications.  


11. Additional information for your injury can be accessed by calling:

DAN Emergency Hotline (+1-919-684-9111) or

Non Emergency (+1-919-684-2948)


Two hours after Lion Fish Envenomation, in the hospital overnight.

Debride the dead tissue/skin.

Day 42, it is almost completely healed over with a very thin layer of new skin which will still take several months to recover.

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