Removing a tic from a patient

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Just curios. I had a new admit come in last night and in report this morning is that he had a tic. The nurse from 3-11 knew about it and didn't remove it. So, I removed it. The question is, would you?

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In a hospital setting.. tick removal should be brought to the doctors attention and performed by the physician. It is a parasite that needs professional treatment and subsequent evaluation.

That being said.. I had one in my scalp (ACCK) didn't know what it was until I pulled that sucker (no pun intended )out!

Little x wiggled his little legs at me after I yanked him out. GEEROSS.

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Specializes in Oncology.
Ewww.

What's a "morel"?

Mushroom.

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Specializes in RN, BSN, CHDN.
In a hospital setting.. tick removal should be brought to the doctors attention and performed by the physician. It is a parasite that needs professional treatment and subsequent evaluation.

That being said.. I had one in my scalp (ACCK) didn't know what it was until I pulled that sucker (no pun intended )out!

Little x wiggled his little legs at me after I yanked him out. GEEROSS.

Me too I freaked out for ages! I kept asking other staff at work to check I wasn't getting a bulls-eye on my scalp LOL.

I was convinced for days that my head ached where it had been, last day I went out gardening

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

I would tell the MD that the patient has a tick and get an order to remove it just to CYA. If the patient get necrotizing fasciitis and you didn't tell anyone before you pulled it......trust me your behind will be the one in the sling for the FIRST thing the MD will say is the you never told him and he would have (of course) immediately removed it himself.

I hate those nasty things. What use are they anyhow? No one eats them, they serve the animal population not good and are harmful to humans. I hate those nasty bugs:madface:. I live in the northeast and they are present in abundance. YUCK! I check my dog and kids ALL the time.:bugeyes: and my son still got a bullseye with me NEVER finding the %&(%^&*^&R tick!

Grrrrrrrrrrr:madface:

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. I've never heard of sending the tick to the lab. That seems unrealistic and Hollywood-esque.

Lmao!! I was thinking the same thing! I can only imagine the stuff he sends to the lab lol. I'm sure the lab folks appease his Hollywood drive, but most of his submissions get filed in the round cabinet

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

Testing of Ticks

People who have removed a tick often wonder if they should have it tested. Some state or local health departments offer tick identification and testing as a community service or for research purposes (such as evaluating infection rates among ticks in an area). Check with your health department; the phone number is usually found in the government pages of the telephone book or online.

CDC - Diagnosis and Treatment - Testing of Ticks - Lyme Disease

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tick! tick! tics are behavioral, ticks are insects. and they are food for many birds; if you keep chickens or have wild turkeys around that really keeps them down.

we live in one of the three counties with the highest incidence of lyme disease in the us, so we're always very aware of ticks. it's estimated that a third of the year-round population on martha's vineyard has lyme antibodies. my dh had lyme from a tick he picked up at a campground in another state, ironically. my nephew in yet another state came home from scout camp and a month later got sick, missing a year of school despite having the biggest work-up known to medicine (dad is a hotshot cardiologist) until one day his mom woke up and remembered that the tick she got off his head when he came home was in the freezer, taped to an index card with the date on it. bingo: lyme. my dad died with complications from lyme, erlichiosis, and babesiosis, all tick-borne, and proof you can always have more than one thing wrong with you. our cats bring them in all the time, usually dog ticks but occasionally deer ticks (which actually spend a lot of their lives on mice...hence the cats' exposure).

if this patient was on hospice it's a moot point. pull it off, entomb in a small length of scotch tape (we have a dispenser on our bedside table, since the cats seem to come to us first) and toss in the wastebasket. wash your hands, and swab the site with an alcowipe.

washing a tick down the sink won't work-- they don't drown and will crawl back up. once just for fun i submerged one in a glass of water to see how long it would take to run out of oxygen-- it was more than 24 hours and it was still crawling around in there.

otherwise, the best use for acrylic nails is as tick-removal tools: grab that little head and wiggle it right out. they also make nifty little tick tools; find them in any camping supply catalog. mine looks like little plastic wire-cutting pliers and you sort of grab and scoop 'em right off the skin, and it has a small lens in the handle to examine the tick and site to see if the tick is intact when removed. if we're at camp i scotch-tape them to a card with the date and place and kid's name, and put it in a ziplock bag and put the bag in the freezer for mom to take home and put in hers. most of the time there's no infection, but if there is, the tick can be tested. the standard is not to test tick or give antibiotics unless there are symptoms. your public health officer can tell you if they want yours for epidemiological study.

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Specializes in Pediatric Critical Care, Cardiac, EMS.

Testing the tick? Seriously? You've got to be kidding me. The tick has to be fastened for over 48 hours in order to transmit any disease, unless you squeeze the abdomen and force them to disgorge the contents into the bloodstream. If your patient shows clinical signs - treat with antibiotics. Both Rocky Mountain Spotted Fever and Lyme Disease - the major tick-borne illnesses - are 100% treatable in the early stages with simple $4 antibiotic prescriptions from Wal-Mart. But the best treatment is prevention - daily tick checks for people in tick prone areas and removal if ticks are found. If you remove the creatures within 24 hours of attachment, you have minimal danger of a systemic infection.

Bringing a tick into the hospital to be tested is as insane as bringing a venomous (or potentially venomous) snake in. Don't do it, please.

I do like the idea of saving the thing on the index card with the date in the freezer in case symptoms appear - that's an excellent thought. But if you're in the backcountry - just throw the thing away and make note of the date and time of the bite. If within a couple weeks your patient is lethargic and depressed - bingo.

Wilderness First Aid Certified, Wilderness First Responder, and working on an eventual Fellowship in Wilderness Medicine.

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(didn't go into all that because it wasn't what the questioner asked. here they say 24 hours, not 48. 90% of the ticks collected at the bsa national jamboree did not carry lyme or any other tick-borne disease...and good lord, we collected a lot of ticks:bugeyes:. generally true about treatment, problem being that diagnosis isn't always as prompt as we could wish. wfa here too. :D)

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Specializes in Pediatric Critical Care, Cardiac, EMS.
(didn't go into all that because it wasn't what the questioner asked. here they say 24 hours, not 48. 90% of the ticks collected at the bsa national jamboree did not carry lyme or any other tick-borne disease...and good lord, we collected a lot of ticks:bugeyes:. generally true about treatment, problem being that diagnosis isn't always as prompt as we could wish. wfa here too. :D)

true enough. just pointing out that testing is unnecessary and expensive in most cases, as well as running the risk of keeping the critters around for longer than necessary. remove 'em and get rid of 'em. clinical signs warrant treatment and maybe testing.

but i do appreciate your point as well - this is more than the original poster asked for.

ultimately, the best bet is to pull 'em off, wash with soap and water, and watch. ymmv, of course, but testing a tick is ridiculous, imo, unless there is something to really raise your index of suspicion way above baseline.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
True enough. Just pointing out that testing is unnecessary and expensive in most cases, as well as running the risk of keeping the critters around for longer than necessary. Remove 'em and get rid of 'em. Clinical signs warrant treatment and maybe testing.

But I do appreciate your point as well - this is more than the original poster asked for.

Ultimately, the best bet is to pull 'em off, wash with soap and water, and watch. YMMV, of course, but testing a tick is ridiculous, IMO, unless there is something to really raise your index of suspicion WAY above baseline.

If you follow the link I gave from the CDC they also say it really isn't necessary to test the ticks.......from the CDC website CDC - Diagnosis and Treatment - Testing of Ticks - Lyme Disease

People who have removed a tick often wonder if they should have it tested. Some state or local health departments offer tick identification and testing as a community service or for research purposes (such as evaluating infection rates among ticks in an area). Check with your health department; the phone number is usually found in the government pages of the telephone book or online.

In general, testing of individual ticks is not useful because:

  • If the test shows that the tick contained disease-causing organisms, that does not necessarily mean that you have been infected.
  • If you have been infected, you will probably develop symptoms before results of the tick test are available. You should not wait for tick testing results before beginning appropriate treatment.
  • Negative results can lead to false assurance. For example, you may have been been unknowingly bitten by a different tick that was infected.

However, you may want to learn to identify various ticks. Different ticks live in different parts of the country and transmit different diseases. For your own peace of mind, you can save a tick that you have removed from yourself and have it tested later, if you wish. Just tape it to a piece of paper or put it in a small container.

But this is asking about a patient in a facility and the doctor should be notified for liability reasons then the tick needs to be removed. Bluegrass......7 ticks from the nether reigions alone :eek:.....you're a better girl than me.

GrnTea I love you but I still hate ticks even if the wild turkey's eat them and my town North of the Vinyard "on the mainland"..........doesn't allow chickens;). When I pull them off my dog with an old pair of hemostats.....I burn the little buggars:devil: and listen to them pop.

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Specializes in Gerontology, Med surg, Home Health.

So glad everyone is an expert on ticks. My neighbor used to use a lit cigarette to burn them off his dog! He had the steadiest hands. My dad got ether from the pharmacist, soaked a cotton ball in it, and held it to the tick. It'd fall asleep, fall off, and then we'd call the neighbor for a lit cigarette.

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