The Humerus NP
Practical Advice from an outspoken Nurse Practitioner
It’s finally (almost) summer in Virginia and I’ve already started seeing patients come to the clinic with sunburn, poison ivy dermatitis, and the ever popular tick bite. I’m not sure about you, but growing up in the south, I had my share of tick bites and I can’t recall one instance when my parents took me to the clinic for it. When I started working in urgent care 5 years ago, I was surprised to see that so many people rush in to be seen for tick bites. I’ve noticed that my patients are generally unnerved by ticks and they are terrified of contracting a tick borne illness, particularly Lyme Disease. Most patients request blood tests and want to be prescribed antibiotics to prevent the onset of illness. So, you may ask yourself (or your healthcare provider), what should I do if I’m bitten by a tick?
First, remove the tick. Using tweezers or a tick removal tool, cautiously pinch as close to your skin as possible. Avoid squeezing the body of the tick, which could cause the tick to regurgitate and be more likely to spread disease. Pull in a steady upward motion & try to remove the entire tick with the mouth attached. If the mouth detaches, cleanse the tweezers with alcohol and gently try to remove the remaining tick from your skin. Cleanse your skin well with alcohol or other antibacterial skin cleanser. Avoid applying petroleum jelly or other home remedies to the bite site. Keep an eye on the bite site, but keep in mind that mild redness and itching are common symptoms of insect bites.
When should I go to the clinic? You should seek medical attention if you experience flu like symptoms; including but not limited to, fatigue, rash, fever, body aches, nausea or vomiting. You may consider keeping the tick for lab testing.
According to the Centers for Disease Control (CDC, 2018)
"The Infectious Disease Society of America (IDSA) does not generally recommend antimicrobial prophylaxis for prevention of Lyme disease after a recognized tick bite.
However, in areas that are highly endemic for Lyme disease, a single dose of doxycycline may be offered to adult patients who are not pregnant and to children older than 8 years of age when all of the following circumstances exist:
a. Doxycycline is not contraindicated.
b. The attached tick can be identified as an adult or nymphal I. scapularis tick.
c. The estimated time of attachment is ≥36 h based on the degree of engorgement of the tick with blood or likely time of exposure to the tick.
d. Prophylaxis can be started within 72 h of tick removal.
e. Lyme disease is common in the county or state where the patient lives or has recently traveled, (i.e., CT, DE, MA, MD, ME, MN, NH, NJ, NY, PA, RI, VA, VT, WI).
Antibiotic treatment following a tick bite is not recommended as a means to prevent anaplasmosis, babesiosis, ehrlichiosis, or Rocky Mountain spotted fever. There is no evidence this practice is effective, and it may simply delay onset of disease. Instead, persons who experience a tick bite should be alert for symptoms suggestive of tick borne illness and consult a physician if fever, rash, or other symptoms of concern develop."
To read more about tick borne illnesses, please visit:
Until next time,
The Humerus NP
Please note: This is intended to be information only and not intended to replace a medical evaluation and advice from your healthcare provider. Please seek medical attention if you suspect that you may have been exposed to a tick borne illness. Thank you.
Melissa is a military spouse, mom, and professional boo boo fixer. She practices as a Nurse Practitioner in Northern Virginia and is passionate about teaching the public how to effectively respond in emergency situations. She founded Rapid Response CPR, LLC in 2017. She blogs to share her medical knowledge in a fun, yet practical way.
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