Do you remove ticks?

[Riley RN]

Hello I'm in my fourth year of (elementary) school nursing and want to say how much I've enjoyed this forum. I learn something every day from all of you and appreciate your input so I'd like to get your opinion on this. Yesterday, a fourth grade student came in with her hair all pulled back exposing her scalp. She complained of a scab on her head. At first glance it did look like a scab, but because she has thick dark hair, I pulled out my trusty magnifying glass. Sure enough, it was a tick - not fully embedded and not at all engorged. She became very very upset (understandably so) and was now complaining that she could feel it biting her (?). I thought that I might have a chance at removing it since it was not embedded, so I gave it a shot. The tick was clinging on for life and the girl was flinching when I tried to remove it. I really did not want to try any further and take the chance that I may not be able to remove it in its entirety. Also, the nagging liability bell was chiming in my ear. I called mom to inform her that she should take her to a doctor or urgent care to have it taken care of. Mom was not at all concerned and said she'd be there in a half hour. So the girl is literally moaning and crying the entire time she was here waiting. She would not let me move farther than an inch away from her. I tried to put her at ease as best that I could. Mom finally shows up 50 minutes later and says that they have a doctor's appointment in 2 hours. Later that day I'm relaying the story to my husband and that I felt so badly for this student because she was so upset. My husband says "you told them to go to the doctor? I've removed ticks on myself plenty of times...what would you do if it was one of our kids?" I said that is completely different, this is not my child, and if I wasn't confident that I could fully remove one from my own child I would do the same thing. I told him that we really are not even supposed to remove splinters (although I do) and he looked at me like I'm crazy. He says "but you're the nurse" Unfortunately, liability is something we have to always keep in mind. Do you think that I handled this correctly?

[scuba nurse, BSN, MSN, RN]

Yes, I would remove a tick if not embedded and then call the parent to inform them so they can check the child for other ticks and to just be aware.

Now, for Lice, that is another thing. I had a parent scream at me because I removed a few live lice from her daughters hair, so I couldn't "prove" to her that her child had lice, and of course she didn't believe me, because you know we gave it to her, because that is what schools do. So the next time her daughter had lice,and I called her I specifically said "Oh and I left them all there for you to get out". I know, totally snarky but I was not taking her crap anymore!

[caliotter3]

I have not been certified in the removal of ticks. In our state it requires a three week course at a state-approved school. (JK!) Good advice here. Guess I would go with calling the parents before the procedure.

[Eleven011]

Can you post an Amazon link of the exact one you have? I want to order one (for personal use with my dig and kids- lol) and there are a few with the same name- want to make sure I am ordering the correct one. Thanks :)

Amazon.com : Tick Twister Tick Remover Set with Small and Large (Pack of 2 Sets) : Pet Supplies

Here is the one I have. I've used them on my kids and pets at home and here at school. They work great!

[Riley RN]

Thank you for all the replies. Ticks are common here in NY as well and it's not something that I haven't personally dealt with before, but I will definitely try Old Dude's method the next time I encounter it. And MrNurse(2) you are spot on with the disclosure suggestion. I knew I had said too much too soon as the words came out of my mouth. You live and you learn........Thanks!

[Jedrnurse, BSN, RN]

I've used both the tick twister and the scoop; they both work very well. (Much preferred to tweezers which are more likely to leave part of the tick in the person.)

[NurseBeans, BSN, RN, EMT-B]

Regardless of how simple a procedure might be, or how common, or even how painless, I would not do anything to a student who is not cooperating or expressing pain or discomfort. I'm not in the business of forcing kids to undergo procedures they don't want.

I mean, not other people's kids.

[Feelgood RN]

I'm not a school nurse, but I like reading your stories! I don't know if this is part of your protocol or not as I hadn't read anything in the comments about it but I think it would be prudent to inform parents of the possibility of known diseases that ticks can cause in your area. I've so far lived in Colorado and Arizona. Lyme disease can be a pretty big deal. If there's no record of a tick bite in a persons history they may have signs/symptoms that go unnoticed or unattributed to the bite. In Arizona there is a massive effort to protect people from developing RMSF and so if people have fever of unknown origin and they've been out in the "wild" or have dogs they will implement RMSF protocol.

Just some food for thought, although looking at pictures of RMSF and thinking about food....

[MHDNURSE]

Amazon.com : Tick Twister Tick Remover Set with Small and Large (Pack of 2 Sets) : Pet Supplies

Here is the one I have. I've used them on my kids and pets at home and here at school. They work great!

Thanks!

[canoehead, BSN, RN]

The easiest tick removal I've done was to use a Qtip and unscrew it counterclockwise. It let go after a couple rotations, and the child denied pain (a six year old).