Safety & First Aid in Australia

Are you in an emergency situation right now? Call triple zero (000) immediately and ask for an ambulance. Start CPR as soon as possible after calling for help.

Travel Safety

Australia is a beautiful and rugged country where you may encounter potentially dangerous wildlife, stinging plants, expansive remote areas and temperatures that can create major health issues. There are several ways you can ensure your safety while visiting Australia’s wild places.

Make sure someone knows where you have gone. If travelling to Australia’s most remote areas might require lodgement of an itinerary with the authorities, but family or friends should be notified prior to regular trips (particularly if travelling alone), with departure and expected arrival /return dates and times in case of any travelling issues.

Ensure your car is roadworthy and suitable for the terrain you are visiting, including spare tyre(s) and a spare set of keys. If venturing to more remote areas, take a tool kit, shovel, essential spare parts, additional food and water and a first aid kit in case things don’t go to plan. You should always ensure that you take adequate clothing, allowing sufficient extra clothing for changeable weather.

If travelling on forest tracks, be alert for possible heavy machinery (e.g. logging vehicles) and other road users or pedestrians. It is recommended that you carry a good quality UHF radio, either installed in your vehicle or hand-held, when travelling on forest tracks. In areas where logging or infrastructure operations occur, vehicles have designated UHF channels to communicate with the ground crews and drivers. It is very handy to know if there is a vehicle coming your way before you meet it head on. You can also let them know of your position by announcing your location (e.g. track you are on) and which direction you are travelling.

A 4WD on a dirt track in remote Australia

Personal Safety

There are many areas in Australia where there may be no services, including fuel stops or mobile phone coverage, for hundreds of kilometres. Personal Locator Beacons (PLBs) and Emergency Position-Indicating Radio Beacons (EPIRBs), are distress beacons that operate on the 406 MHz range and can be purchased or hired in Australia for land, maritime and air usage. PLBs are smaller and more easily transported, so are recommended for land-based travel. They are designed to be carried by individuals, and the emitted signal will operate continuously for a minimum of 24hrs once activated. EPIRBs are larger and are required by boats travelling more than 2km from shore. Once activated, they will emit a signal for a minimum of 48hrs. The signal of both is detected by satellites, though models with an inbuilt Global Positioning System (GPS) allow for greater accuracy and faster detection of location. These devices can save your life if you are not able to contact emergency services by phone or radio (see www.beacons.amsa.gov.au/index.asp for more information). Prior to leaving on a trip, you should check that your beacon registration is current and your emergency contact’s details are up to date. You should also register your trip details and itinerary.

First Aid Kit with Personal Locator Beacon

When walking a hat is essential for keeping the sun off your head and face and good walking shoes are a must. Wear sunscreen, even on overcast days, and insect repellent (biting insects, especially mosquitoes, have the potential to spread disease). Ensure you carry adequate drinking water and drink frequently.  Carry an up-to-date first aid kit, including at least two pressure immobilisation bandages and make yourself aware of first aid practices.

In the Event of an Emergency

In the event of an emergency within Australia, the triple zero (000) service is the quickest way to receive help:

  • Dial Triple Zero ‘000’
  • Stay calm
  • Request Police, Fire or Ambulance when asked which service you require
  • Provide your location (try and provide as much detail as possible)
  • If you are travelling, state the direction and destination of travel and the most recent landmark or intersection you passed
  • Stay on the line for further instructions. 

Note: other emergency numbers for mobile devices are 112 and 106, and you can also download the Emergency + Smartphone App to your phone or device

Avoiding Dangerous Encounters

While encounters with potentially dangerous animals are common in Australia (especially in wilderness areas), it is unusual that an encounter results in serious injury and fatalities are very rare. Advances in medical research have provided us with the first aid measures, antivenoms and other medical treatments to reduce the severity of animal-related injuries and disease. It would also be wise to familiarise yourself with first id treatments for any common venomous animals prior to travelling to an area.

A female Saltwater (or Estuarine) Crocodile resting on a muddy riverbank in dappled sunlight under some mangroves

Crocodiles

Be crocwise

  • Do not enter water that may contain crocodiles (often indicated by signs, but not always, so please check with local authorities).
  • Do not clean fish on the edge of a waterway in areas where crocodiles are present.
  • Do not camp next to a waterway.
  • Be aware that crocodiles can be present in the ocean too.
  • Respect crocodiles and view them from afar- these can be extremely fast moving and are often underestimated.

Snakes and Arthropods

  • Never attempt to catch a snake.
  • Never attempt to kill a snake – this is not only illegal, but will also put yourself at serious risk (20% of all fatalities from snake bite occur as a result of the victim trying to handle or kill the snake).
  • Never place your hands and feet where you cannot see them.
  • Never walk around at night without a torch.
  • Always wear shoes and long pants in locations where these creatures will likely be present.
  • Keep rodents away from houses.
  • Keep yards and shed tidy and free of clutter.
  • Keep birds away from houses – their seed attracts rodents which in turn attract snakes.
  • Take care when turning over potential shelter sites such can corrugated iron sheets, rocks and logs, as well as other debris.
  • Store shoes inside so nothing can seek out shelter inside the shoe.
  • Stay away from nests and hives.
  • Use approved insect repellents and accessories (face and head nets, etc).
  • Install and maintain screens on windows and doors.
An Eastern Brown Snake on the grass making a threatening display.
A Stephen's Banded Snake lightly coiled on the bush floor
Zebra Fish

Venomous aquatic species

  • Wear good shoes when walking through rivers and estuaries, on reefs and intertidal zones.
  • Do not handle or otherwise provoke wildlife, avoid handling shells than might still contain an animal.
  • Wear gloves when handling fish.
  • Take care when removing fish and other creatures from nets and lines.
  • Do not antagonise fish when diving.
  • Always wear stinger suits when diving or swimming in northern Australia.

First Aid

Dial ‘000’ (triple zero) for an ambulance in any medical emergency.

If someone is bitten or stung by an animal, the early application of the correct first aid practices can greatly increase the chances of the patient making a full recovery. First aid measures are constantly advancing and improving, so it is important to stay current with the latest practices.

In the First Instance

The DRSABCD action plan should be followed:

D – look for Danger

R – check for Response

S – Send for help

A – clear the Airway

B – sustain Breathing

C – start CPR (if required) 

D – apply a Defibrillator if indicated. 

(DRSABCD is vital if a person has collapsed and is unresponsive)

Portable Defibrillator in yellow case

Cardiopulmonary Rescucitation (CPR)

How to perform CPR on an adult — Watch this video from Royal Life Saving Australia about how to perform CPR.

How to perform CPR on a child over 1yrs — Watch this video from Royal Life Saving Australia about how to perform CPR.

How to perform CPR on a baby or child under 1yrs — Watch this video from Royal Life Saving Australia about how to perform CPR.

Pressure Immobilization Bandaging (PIB) First Aid

This is currently the recommended treatment for bites and stings of Australian venomous snakes, funnel-web spiders, Blue-ringed Octopuses and cone shells.

There are two components that must be satisfied – pressure over the bitten limb and focal plus general immobilization. This involves the application of:

  1. A broad (minimum 75mm wide) elastic bandage to the entire bitten limb at a very firm pressure of at least 40mmHg for an arm and 55mmHg for a leg. The Australian Venom Research Unit (AVRU) recommends SETOPRESS TM High Compression Bandages as these bandages relax very little with prolonged application. 
  2. Splints to effectivity immobilize the entire limb, in combination with laying the patient down and completely still to minimize any movement. Do not use a sling.

Move away from the area where the bite or sting occurred (if required), lie the patient down and keep them calm. Any movement of the limb quickly results in venom absorption and must be prevented; therefore first aid must be an immediate priority after a snake bite.

Do not allow the patient to walk. We recommend that in the case of a snake bite to a lower limb, splinting of both legs should be carried out to completely immobilize the lower half of the body.

In rare cases, a person may be bitten on the body, face or neck. In these cases direct pressure should be applied over the bite site with a pressure pad made from a cloth (a hand towel, t-shirt etc) and held firmly in place until medical attention can be sought. Always seek medical attention following a snake bite.

Pressure Immobilisation bandage applied to a leg with a splint

Venomous Snake, Funnel-web Spider, Mouse Spider & Blue-ringed Octopus Bites and Cone Snail Stings

  • Seek urgent medical help by dialing triple zero ‘000’
  • Do Not wash the bite site
  • Apply a pressure immobilisation bandage and splint (if a limb)
  • Monitor the patient’s breathing, pulse and circulation to the extremities and begin CPR (30 chest compressions followed by 2 rescue breaths) if required and continue until the patient’s breathing is normal and stable
  • Do Not catch, chase or kill the snake, spider, octopus or cone snail – this is extra movement (if done by the patient) and could result in further bites or stings
  • Do Not drink Alcohol, tea, stimulants, food or medication without expert advice
  • Do Not wash the wound, apply hot or cold packs, electrical shocks, suction devices or tourniquets/ligatures.
An Eastern Mouse Spider looking toward the camera from a leaf
Red-backed Spider on a piece of wood

Red-back Spider Bites

  • Wash the bite site
  • Apply ice packs
  • Do Not apply a bandage
  • Seek medical attention if more severe symptoms develop

Tick Bites

  • Do Not use methylated spirits or alcohol to kill the tick prior to removal
  • Remove the tick using fine tweezers, by grasping behind the head (as close to the patient’s skin as possible), and gently pull straight (keep for identification)
  • Ensure that all parts of the tick have been removed
  • Do Not squeeze the body
  • Wash the site with warm water
  • Apply an antiseptic
  • Apply a local bandage (e.g. band aid) for 24 hours
  • Seek medical attention if more severe symptoms develop
A Bush Tick on skin of hand
European Honeybee on a blue flower

Bee Stings

  • Remove the stinger barb by scraping sideways
  • Do Not squeeze the venom sac dislodged from bee abdomen
  • Wash the site
  • Apply ice packs
  • If the person is allergic:
    • remove stinger barb, if still present
    • lay the patient flat, or seated if breathing is difficult
    • follow guidelines under ‘Respiratory Insufficiency Management’ (below)
    • dial triple zero ‘000’
    • Do Not allow the person to move around

Wasp Stings

  • Wash the site with warm soapy water
  • Apply ice packs
  • If the person is allergic:
    • remove stinger, if still present
    • lay the patient flat, or seated if breathing is difficult
    • follow guidelines under ‘Respiratory Insufficiency Management’ (below)
    • call triple zero ‘000’
    • Do Not allow the person to move around
European Wasp
Smooth Stingray swiming under water
Lionfish in an aquarium

Stonefish, Stingrays and other Venomous Fish Stings

  • Do Not remove any penetrating barbs (stingrays).
  • Any stingray wound to the trunk of the body should be treated as a medical emergency, seek urgent medical attention by dialling triple zero ‘000’
  • Stem any major bleeding as the highest priority
  • Immerse the site with hot water (45°C), Not scalding, water for 20 minutes
  • Remove briefly and repeat the process until pain subsides (Not longer than 2 hours)
  • If symptoms persist, seek urgent medical attention by dialling triple zero ‘000’ (antivenom is available for stonefish)
  • Any lacerated wounds should be checked and treated by a medical professional for secondary infections.
  • If the person is allergic:
    • remove allergen, if still present
    • lay the patient flat, or seated if breathing is difficult
    • follow guidelines under ‘Respiratory Insufficiency Management’ (below)
    • call triple zero ‘000’
    • Do Not allow the person to move around

Sea Urchins and Crown-of-thorns Starfish Stings

  • Immerse the site with hot water (45°C), Not scalding, water for 20 minutes
  • Remove briefly and repeat the process until pain subsides (Not longer than 2 hours)
  • If symptoms persist, seek urgent medical attention by dialling triple zero ‘000’
  • If the person is allergic:
    • remove allergen, if still present
    • lay the patient flat, or seated if breathing is difficult
    • follow guidelines under ‘Respiratory Insufficiency Management’ (below)
    • call triple zero ‘000’
    • Do Not allow the person to move around
Box Jellyfish (Chironex spp.)

Box Jellyfish image courtesy of Guido Gausch [Avispa marina.jpg: Guido Gautsch, Toyota, Japanderivative work: Mithril / CC BY-SA (https://creativecommons.org/licenses/by-sa/2.0)]

Bluebottle or Portugueses Man 'o' War on a sandy beach

Cnidarian Stings (including Box Jellyfish, True Jellyfish and Portuguese Man O’War)

Continuing studies and clinical trials are constantly reviewing and updating these procedures, and readers are recommended to remain up to date with current first aid guidelines from scientific trials. First aid measures may change for individual species.

  • Seek urgent medical help by dialing triple zero ‘000’
  • Do Not scrape the sting site to remove tentacles and stinging cells. Evidence suggests that <1% of stinging cells discharge on initial contact, so poor removal techniques can dramatically increase the amount of venom injected into the patient
  • Do Not wash the area with sea water or scrub with sand
  • Flood the site generously with vinegar for at least 30 seconds
  • If vinegar is not available, carefully remove tentacles by ‘plucking’
  • Immerse the area in hot water (45°C) for 45 minutes
  • Do Not apply ice packs
  • Do Not use ethanol, this increases pain and discharge of stinging cells
  • Monitor the patient’s breathing, pulse and circulation to the extremities

Respiratory Insufficiency Management

Envenomation related difficulty in breathing can be due to true Anaphylaxis as well as to Anaphylactoid reactions.

Anaphylaxis is an Immunoglobulin E (IgE) mediated response and requires previous exposure to the allergen.

Symptoms include acute, rapid onset illness, with typical clinical symptoms appearing as:

  • Tingling around the mouth
  • Swelling of the lips, tongue and face
  • Tightness in the throat
  • Difficult or noisy breathing
  • Difficulty talking
  • Coughing
  • Dizziness
  • Vomiting or abdominal pain – particularly following insect stings
  • Pale and floppy (infants and young children)

If anaphylaxis is suspected:

  • Seek urgent medical help by calling triple zero ‘000’
  • Lay the person flat (or seated if breathing is difficult)
  • Obtain and follow the instructions on an epinephrine (adrenaline) pen – usually injected in outer thigh
  • Do Not allow the patient to stand or walk around
  • Monitor breathing and commence CPR (30 chest compressions followed by 2 rescue breaths) if required and continue until the patient’s breathing is normal and stable
  • Monitor patient for at least 4 hours

Anaphylactoid reactions produce the same clinical picture with anaphylaxis but are not IgE mediated.

This may occur through a direct nonimmune-mediated release of mediators by venom toxins from mast cells and/or basophils or result from direct complement activation by venom components. Only true IgE mediated Analyphylaxis should be managed by the administration of epinephrine.

Box jelly stings, as well as certain other jelly stings, can lead to respiratory insufficiency but in these cases “catecholamine surge” is possible, in which the patient undergoes a hypertensive phase. Administration of epinephrine for anaphylactoid reactions due to jellyfish stings can lead to end organ failure and cerebral haemorrhage.

Illustration of person with suspected anaphylaxis

Image Source: Blausen.com staff (2014). &quot;Medical gallery of Blausen Medical 2014&quot;. WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.010. ISSN 2002-4436. / CC BY (https://creativecommons.org/licenses/by/3.0)

Epi Pens

References

Doyle, T. K., Headlam, J. L., Wilcox, C. L., MacLoughlin, E. & Yanagihara, A. A. (2017). Evaluation of Cyanea capillata sting management protocols using ex vivo and in vitro envenomation models. Toxins 9 (7): 215 DOI: 10.3390/toxins9070215.

Ihama, Y., Fukasawa, M., Kenji, N., Kawakami, Y., Nagai, T., Fuke, C. & Miyazaki, T. (2014). Anaphylactic shock caused by sting of crown-of-thorns starfish (Acanthaster planci). Forensic Science International 236, e5-e8.

Lee, A. & Yanagihara, A. A. Insights into the mechanistic basis of the Irukandji Syndrome by evaluating the hematologic and immunologic responses in whole blood 2011. hdl. handle.net/10125/29642.

Tibballs, J., Yanagihara, A. A., Turner, H. & Winkel, K. (2011). Immunological and toxicological responses to jellyfish stings. Inflammation and Allergy Drug Targets. 2011 Oct 1;10(5): 438–446. PMCID: PMC3773479.

White, J. (2013). A Clinician’s Guide to Australian Venomous Bites and Stings. BioCSL, Parkville, Melbourne.

Wilcox, C. L. & Yanagihara, A. A. (2016). Heated debates: hot-water immersion of ice packs as first aid for cnidarian envenomations? Toxins 8 (4): 97 DOI: 10.3390/toxins8040097.

Wilcox, C. L., Headlam, J. L, Doyle, T. K. & Yanagihara, A. A. (2017). Assessing the efficacy of first-aid measures in Physalia sp. envenomation, using solution and blood agarose-based models. Toxins 2017, 9 (5), p. 149.

Yanagihara, A. A. & Shohet, R. V. (2012). Cubozoan venom-induced cardiovascular collapse is caused by hyperkalemia and prevented by zinc gluconate in mice. PLoS One 7 (12) e51368.

Yanagihara, A. A., Wilcox, C., King, R., Hurwitz, K. & Castelfranco, A. M. (2016). Experimental assays to assess the efficacy of vinegar and other topical first-aid approaches on cubozoan (Alatina alata) tentacle firing and venom toxicity. Toxins (Basel) 2016:8(1). pii: E19. doi: 10.3390/toxins8010019.

Yanagihara, A. A., Wilcox, C., Smith, J. & Surrett, G. W. (2016). Cubozoan envenomations: clinical features, pathophysiology and management, in Goffredo, S. & Dubinsky, Z. (eds), The Cnidaria, Past, Present and Future. The World of Medusa and Her Sisters. Springer International Publishing, Switzerland, pp. 637–652.

Yanagihara, A. A. & Wilcox, C. (2017). Cubozoan sting-site seawater rinse, scraping, and ice can increase venom load: upending current first aid recommendations. Toxins 2017, 9 (3), 105.

Yoshimoto, C. M. & Yanagihara, A. A. (2002). Cnidarian (coelenterate) envenomations in Hawai’i improve following heat application. Transactions of the Royal Society for Tropical Medicine and Hygiene 2002:96: 300–303.

Disclaimer

The information and instructions outlined above were current ay the time of writing, and every attempt has been made to ensure its accuracy. Professional advice should always be saught in any medical emergency.