Tick Removal

Remove the tick as soon as possible to reduce the chances of infection

• Use a pair of clean tweezers to grasp the head of the tick as close to the skin as possible

• Pull upward using slow, steady and even pressure

  • Avoid twisting or jerking movements - these can cause the tick's mouth to break off and remain in the skin

  • If this happens, remove the rest of the tick with tweezers

  • If you cannot do this easily, leave the skin alone and let it heal

• After removing the tick, clean the bite area and your hands with soap and water or an alcohol-based sanitizer

• If you are planning to take your child to see a doctor and want to bring the tick:

  • Put the tick in a sealed plastic bag or sealed container -and-

  • Record the date your child was bitten -and-

  • Where on your child's body the tick bit them -and-

  • Where the bite may have occurred (city, state, country) especially if your family has traveled in the past month

-or-

• Get rid of a live tick by:

  • Putting it in rubbing alcohol -or-

  • Placing it in a sealed bag or container (such as an empty pill bottle) -or-

  • Wrapping it tightly in tape -or-

  • Flushing it down the toilet

Avoid trying to crush the tick with your fingers

Things to avoid when removing a tick as any of these choices can cause the tick to release stomach contents into the bite area and increase the risk of infection:

• Burning the tick

• Smothering the tick with - 

  • Nail polish

  • Essential oils

  • Petroleum jelly

  • Nail polish remover

Visit your health care provider as soon as possible if:

• You are not comfortable removing the tick from your child

• You are unable to remove the tick

• Your child has a fever, rash or other symptoms (tiredness, muscle pain, joint swelling, or joint pain) after the tick bite

References

Centers for Disease Control and Prevention. (2021). Tick bite: What to do (CDC Publication No. CS310465-A). U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. https://cdc.gov/ticks/pdfs/FS_TickBite-508.pdf

Lantos, P. M., Rumbaugh, J., Bockenstedt, L. K., Falck-Ytter, Y. T., Aguero-Rosenfeld, M. E., Auwaerter, P. G., Baldwin, K., Bannuru, R. R., Belani, K. K., Bowie, W. R., Branda, J. A., Clifford, D. B., DiMario, F. J., Halperin, J. J., Krause, P. J., Lavergne, V., Liang, M. H., Meissner, H. C., Nigrovic, L. E.,...Zemel, L. S. (2021). Clinical practice guidelines by the Infectious Diseases Society of America (IDSA), American Academy of Neurology (AAN), and American College of Rheumatology (ACR): 2020 guidelines for the prevention, diagnosis and treatment of Lyme disease. Clinical Infectious Diseases, 72(1), e1-e48. https://doi.org/10.1093/cid/ciaa1215 



Pace, E. J., & O'Reilly, M. (2020). Tickborne diseases: Diagnosis and management. American Family Physician, 101(9), 530-540. https://www.aafp.org/afp/2020/0501/p530.html


These pathways do not establish a standard of care to be followed in every case. It is recognized that each case is different, and those individuals involved in providing health care are expected to use their judgment in determining what is in the best interests of the patient based on the circumstances existing at the time. It is impossible to anticipate all possible situations that may exist and to prepare a pathway for each. Accordingly, these pathways should guide care with the understanding that departures from them may be required at times.