II. Technique: Manual tick extraction

  1. Tools
    1. Blunt angled forceps with medium size to fine tips
    2. Specific Tick Removal devices
      1. Sawyer Tick Pliers (B & A Products)
      2. Pro-Tick Remedy (SCS Limited)
      3. Ticked Off (Ticked Off, inc.)
  2. Removal
    1. Grasp tick as close to embedded mouth as possible (closest to skin), and avoid crushing
    2. Gently pull perpendicular to skin without twisting and tick will eventually release
  3. Post-extraction care
    1. Retained parts of mouth or head may be left and will fall away in the subsequent days
      1. No need to dig for tiny retained parts
    2. Apply antiseptic to extraction sites (e.g. Alcohol, betadine, hibiclens)
    3. Observe for complication signs (e.g. local infection)
    4. See Lyme Disease for Post-exposure Prophylaxis

III. Precautions: Methods to avoid

  1. Avoid using sharp forceps
  2. Avoid crushing or puncturing tick body
  3. Do not apply solvents to tick
  4. Do not apply Lidocaine, gas, or vaseline to tick (ineffective and risk of local reaction)
  5. Do not apply hot match or nail to tick
  6. Do not twist tick head to remove
  7. Do not thread Suture Needle through tick

IV. References

  1. Green and Millsap (2016) Crit Dec Emerg Med 30(1): 4
  2. Hensley and Swaminathan in Herbert (2016) EM:Rap 16(7): 7-9
  3. Haynes in Pfenninger (1994) Procedures, p. 125-6
  4. Gammons (2002) Am Fam Physician 66:643-6 [PubMed]

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