TechniqueThe standard recommendations for toxin denaturation as a first-aid measure call for immersing the affected area in hot freshwater with an upper limit of 113°F (45°C) for 30 to 90 minutes. This may work reasonably well when the toxin inoculation is skin deep, such as with a jellyfish sting, but will be less effective when toxins have been inoculated by means of deeper puncture wounds, as is the case of lionfish spines. Though quick reasoning could call for increasing the temperature, applying higher temperatures at skin level in an attempt to reach the desired temperature at a deeper level poses an unacceptable risk of burning the skin. In addition, vasodilatation caused by exposure to elevated temperatures may expedite the onset of absorption and of systemic effects.
Each case is unique and requires some estimation of the depth to which the venom was injected; for superficial inoculations, application of heat might be useful to manage pain and denature toxins, whereas for deeper inoculations, heat is for pain management only.