With Hawaii's unique environment, we wanted to provide you with a first aid guideline to some common injuries you may encounter while adventuring in Hawaii. As always, please consult your physician for further information on specific medical conditions or symptoms that you may have, and do not hesitate to seek immediate professional medical attention if your symptoms worsen or the pain becomes increasingly unbearable.
Corals are animals that have outer skeletons with sharp edges. Because coral formations are rigid and sharp, injury can occur after accidental contact, leaving a small amount of coral material in the wound. Most minor coral scrapes and cuts can be treated at home. First, the cut needs to be properly cleaned out. We suggest scrubbing the wound lightly using a towel, warm water, and mild soap for five minutes, then rinse the cut with fresh water. This is to remove coral particles. The cut should also be cleaned with hydrogen peroxide to help clean out bacteria and to disinfect. After the hydrogen peroxide, the cut can be rinsed again with fresh water. A topical antibiotic, like bacitracin, should be applied routinely to prevent further infection. The wound may also be bandaged to prevent irritation or dirt from getting into the wound. Be patient since a cut from coral can take weeks to completely heal. However, you should also watch for signs and symptoms of infection. Increased pain, swelling, pus draining, fever, and spreading redness or red streaks of the skin around the wounded area suggests expanding infection and requires immediate medical attention.
Jellyfish have tentacles that are covered in nematocysts (little sacs) that are filled with poison that can cause a painful to sometimes life-threatening sting. Jellyfish are usually found near the surface of the water when there is low light (in the evening). If stung, do not rub the tentacles with your hands, clothing, or sand. Soak a compress with vinegar and hot water, and apply to affected area for 10 to 15 minutes. If vinegar is unavailable, rinse with large amounts of salt water. Do NOT use urine, fresh water, gasoline, turpentine, or kerosene. Fresh water will cause the nematocysts to continue releasing toxin. If vinegar is unavailable, baking soda or household ammonia may be useful. Baking soda can be made into a paste with water and applied to the area. Ammonia should be mixed with water in a 1:3 ratio (1/4 cup ammonia with 3/4 cup water), then soak a cloth in the mixture, and place in area. Rinse eye stings with saline solution only. Do not put alcohol, vinegar, or any other “stinger solution” in the eyes. After decontamination, the tentacles should be removed. Remove the tentacles using a stick, tweezers, or gloved hand. Be sure not to rub or press the tentacles in or touch them with other skin. If available, apply a lather of shaving cream, soap, or a paste made of baking soda. The stinging cells will be picked up in the lather and can be scraped off using a knife edge or edge of a credit card. After removal of the tentacles, the area can be treated again with vinegar. An antihistamine (Benadryl) or topical steroid (hydrocortisone cream) can help with itching. Ibuprofen or acetaminophen can help with pain. The wound should be cleaned regularly afterwards and should have a topical antibiotic applied to prevent infection.
Centipedes are fairly common around Hawai’i. When a centipede bites its victims, it secretes a venom into its victims as well. The venom is nontoxic in most cases, but it is possible for a person to have a severe allergic reaction to the venom. Centipede bites usually present with severe pain, localized redness and swelling, and localized itching. Depending on the location of the bite and the person, swollen lymph nodes may be present. There will also be two small puncture wounds from the bite. The treatment for centipede bites is fairly basic. Tight fitting jewelry near the bite should be removed as soon as possible. Jewelry left on could cutoff circulation if swelling became severe. Icing the area will help to decrease pain, inflammation, and swelling. For pain, the patient can take acetaminophen or ibuprofen. For itching, an antihistamine (Benadryl) is a logical choice. The bite should be washed with water and mild soap. A topical antibiotic can be applied if there is an open wound if there is a concern about infection. Signs of a serious allergic reaction to a centipede bite are problems breathing, swelling of the tongue, feeling faint, or developing hives. In such cases, you should seek professional medical treatment or call 911.
Wana or Sea Urchin
Wana (vah-nah), also known as sea urchins, are small, spiny, globular animals. Wana are only 1 to 4 inches in diameter, but can cause pain when encountered. Sea urchins have spines that produce puncture wounds, and they have pedicellaria that release venom when they attach. The puncture wounds can cause swelling, pain, and redness, and may lead to infection. To treat, immerse the area in hot water for 30 to 90 minutes. The water should be as hot as tolerable. Don’t have the water so hot that it burns the skin because then you would have another problem on your hands. After soaking, use tweezers to pull out the spines. If available, apply a lather of shaving cream, soap, or a paste made of baking soda. The pedicellaria will be picked up in the lather and can be scraped off using a knife edge or edge of a credit card. Then scrub the wound with soap and water and rinse with fresh water. Do not close the wound with tape of skin glue to avoid trapping remaining particles inside. Apply a topical antibiotic 2 to 3 times daily to prevent infection. Acetaminophen or ibuprofen can be taken for pain. Seek medical attention if signs of infection like pus, increased redness or swelling, and fever occur.
We hope this information can help with any mishaps you may encounter while enjoying your time in Hawai’i! For more information or to consult to a specialist, be sure to visit one of our six convenient Foodland pharmacy locations located on Oahu at Kailua  and Laie , Kauai at Princeville  and Waipouli , Maui at Pukalani , and the Big Island at Waimea .