Why must fresh water be avoided when rinsing an active Man-o'-War sting immediately after contact?

Answer

It causes undischarged nematocysts to fire their venom, escalating the sting.

A critical point in treating a Man-o'-War sting is avoiding rinsing with fresh water, which includes tap water. Fresh water creates a hypotonic environment that triggers the microscopic stinging cells, known as nematocysts, which may still be clinging to the skin surface, to discharge any remaining venom payload. This action directly exacerbates the envenomation by injecting more toxin into the affected area, significantly increasing the patient's suffering and the severity of the resulting injury. The correct first step is using seawater to gently clear loose material before chemical deactivation.

Why must fresh water be avoided when rinsing an active Man-o'-War sting immediately after contact?
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