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Tick removal

Ticks are small, insect-like creatures that live in woods and fields. They attach to you as you brush past bushes, plants, and grass. Once on you, ticks often move to a warm, moist location, like the armpits, groin, and hair. They typically attach firmly to your skin and begin to draw blood for their meal. This process is painless and most people will not notice the bite.

Ticks can be fairly large -- about the size of a pencil eraser -- or so small that they are almost impossible to see. Ticks can cause a variety of health conditions ranging from harmless to serious.

See also: Tick bites

Symptoms

While most ticks do not carry diseases, some ticks can cause:

Watch for the symptoms of these diseases in the weeks following a tick bite:

  • Fever
  • Headache
  • Muscle or joint aches
  • Other flu-like symptoms
  • Stiff neck
  • Swollen lymph nodes
  • Weakness

Watch for a red spot or rash starting at the location of the bite.

The tick itself can cause paralysis in humans (called tick paralysis). Symptoms include:

  • Incoordination
  • Numbness
  • Spreading paralysis
  • Tingling
  • Weakness

Do Not

  • Do NOT try to burn the tick with a match or other hot object.
  • Do NOT twist the tick when pulling it out.
  • Do NOT try to kill, smother, or lubricate the tick with oil, alcohol, vaseline, or similar material.

Call immediately for emergency medical assistance if

Call your doctor if you have not been able to remove the entire tick. Also call if in the days following a tick bite you develop:

Call 911 if you have any signs of:

First Aid

If a tick is attached to you, follow these steps to remove it:

  1. Grasp the tick close to its head or mouth with tweezers. Do not use your bare fingers. If needed, use a tissue or paper towel.
  2. Pull it straight out with a slow and steady motion. Avoid squeezing or crushing the tick. Be careful not to leave the head embedded in the skin.
  3. Clean the area thoroughly with soap and water. Also wash your hands thoroughly.
  4. Save the tick in a jar and watch carefully for the next week or two for signs of Lyme disease.
  5. If all parts of the tick cannot be removed, get medical help. Bring the tick in the jar to your doctor's appointment.

Prevention

  • Wear long pants and long sleeves when walking through heavy brush, tall grass, and densely wooded areas.
  • Pull your socks over the outside of your pants to prevent ticks from crawling up inside.
  • Keep your shirt tucked into your pants.
  • Wear light-colored clothes so that ticks can be spotted easily.
  • Spray your clothes with insect repellant.
  • Check your clothes and skin frequently while in the woods.

After returning home:

  • Remove your clothes and thoroughly inspect all skin surface areas, including your scalp. Ticks can quickly climb up the length of your body.
  • Some ticks are large and easy to locate. Other ticks can be quite small, so carefully evaluate all black or brown spots on the skin.
  • If possible ask someone to help you examine your body for ticks.
  • An adult should examine children carefully.

References

Bolgiano EB, Sexton J. Tick-borne illnesses. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 132.

Updated: 1/2/2011

Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.


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