Criteria for a major sting by a Chirodropid (box jellyfish):
(1) covering an area more than half of one limb (especially in children)
(2) associated with impairment of consciousness
(3) associated with impaired breathing
(4) associated with impaired circulation (with need for resuscitation)
(5) associated with extreme pain
Patients with a major sting by a Chirordopid should receive immediate medical attention and be transported to a medical facility. Immediate care may include:
(1) airway maintenance, including intubation, with supplemental oxygenation
(2) insertion of vascular lines
(3) monitoring of ECG, urine output and vital signs
(4) intravenous administration of antivenom if available
(5) analgesics
(6) vasopressors to maintain blood pressure
