LAAngler, if you start to develope any kind of shortness of breath, itching, or hives, it is imperative to seek immediate emergency care. These are indications of anaphalaxis (allerigic reaction) and an cause some serious problems w/ airway constriction, simialr to a bee sting. This is very, very rare, most just have extreme localized pain w/ swelling and redness. The heat opens capilliaries to increase blood flow to the area, while ice consrticts those same vessels for the opposite effect.
To answer your question, no a trip to the er is not necessary if you are prepared to handle the incident. A little first aid on the boat is all that is needed. Some people do not handle pain well and do need to go in, just remember everyone is different, so what works for one - may not work on the next person.
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