Tick removal

Indications

1. Tick attachment to the skin

Contraindications

1. None

Equipment

1. Gloves
2. Fine-toothed forceps
3. Fine suture

Technique

1. Apply viscous lidocaine to kill the tick and anesthetize bite site
2. Grasp tick with forceps as close to skin surface as possible and pull upward with steady, even traction.
3. Alternatively, fine suture looped in a half-hitch around the tick between the skin and tick's body
4. Take care not to squeeze or crush the tick body because this may expel infective agents.
5. Do not twist or jerk the tick in order to prevent the mouth parts from breaking off during extraction.
6. If mouth parts are left behind after removal of the body, they may be removed with tweezers.
7. If one is still unable to remove the mouth parts, excision under local anesthesia will be needed to prevent local infection
8. Once tick is removed wash the bite area with soap and water or antiseptic.
9. Save tick in plastic bag for ID and aid in diagnosis if illness occurs.

Complications/Follow-up

1. Monitor for signs and symptoms of tick-borne disease
2. Routine antimicrobial prophylaxis or serologic testing is not recommended
3. There is potential for secondary infections

See Also

• Tick borne illnesses

References

• Roberts & Hedges, Clinical Procedures in Emergency Medicine, 5th ed.

Authors

Edgardo Ordonez, Silas Chiu, Neil Young, Jordan Swartz