Emergency Department Presentations for Jellyfish Stings in Southern China: A Cross-Sectional Analysis of Pain Severity and Treatment Timing

Purpose: To analyze and discuss the clinical characteristics of jellyfish stings in the South China Sea and to identify factors associated with post-sting pain. Patients and Methods: The study population included individuals stung by jellyfish along the coasts of Hainan and Guangdong Provinces, recruited from two regional hospital emergency departments.A cross-sectional study was conducted using a structured questionnaire. Univariate and multivariate logistic regression analyses were performed on the collected data. Pain intensity was assessed using the Numerical Rating Scale (NRS) and used as the basis for grouping participants. Receiver operating characteristic (ROC) curve analysis was applied to determine the optimal time interval between sting occurrence and medical treatment. Results: A total of 436 questionnaires were distributed, and 376 were returned (response rate: 87.6%). After screening, 316 valid questionnaires were included in the final analysis (validity rate: 84.0%). Based on NRS scores, participants were categorized into three groups: Group 1 (mild pain, NRS 0– 3), Group 2 (moderate pain, NRS 4– 6), and Group 3 (severe pain, NRS 7– 10). Baseline characteristics were comparable across the three groups. Univariate analysis identified eight factors associated with NRS scores: sting on the face or neck, sting on the chest or abdomen, skin edema, skin wound bleeding, skin wound infection, seawater rinsing, hot compress/hot water immersion, and time interval from sting to medical treatment (all P < 0.05). Multivariate logistic regression revealed six independent predictors of higher pain scores: sting on the face or neck, skin edema, skin wound bleeding, seawater rinsing, and hot compress/hot water immersion (all P < 0.05). ROC curve analysis indicated that receiving medical treatment within 28 minutes of the sting was associated with significant pain relief. However, it may be delayed due to logistics and transportation time. Conclusion: Multiple factors influence pain severity following jellyfish stings. Prompt and appropriate initial non-pharmacological management, followed by timely medical treatment preferably within 28 minutes can help alleviate pain and improve clinical outcomes.