II. Technique: Manual tick extraction
- Tools
- Blunt angled forceps with medium size to fine tips
- Specific Tick Removal devices
- Sawyer Tick Pliers (B & A Products)
- Pro-Tick Remedy (SCS Limited)
- Ticked Off (Ticked Off, inc.)
- Removal
- Grasp tick as close to embedded mouth as possible (closest to skin), and avoid crushing
- Gently pull perpendicular to skin without twisting and tick will eventually release
- Post-extraction care
- Retained parts of mouth or head may be left and will fall away in the subsequent days
- No need to dig for tiny retained parts
- Apply antiseptic to extraction sites (e.g. Alcohol, betadine, hibiclens)
- Observe for complication signs (e.g. local infection)
- See Lyme Disease for Post-exposure Prophylaxis
- Retained parts of mouth or head may be left and will fall away in the subsequent days
III. Precautions: Methods to avoid
- Avoid using sharp forceps
- Avoid crushing or puncturing tick body
- Do not apply solvents to tick
- Do not apply Lidocaine, gas, or vaseline to tick (ineffective and risk of local reaction)
- Do not apply hot match or nail to tick
- Do not twist tick head to remove
- Do not thread Suture Needle through tick
IV. References
- Green and Millsap (2016) Crit Dec Emerg Med 30(1): 4
- Hensley and Swaminathan in Herbert (2016) EM:Rap 16(7): 7-9
- Haynes in Pfenninger (1994) Procedures, p. 125-6
- Gammons (2002) Am Fam Physician 66:643-6 [PubMed]
