Paralysis Tick

 First aid for tick envenomation is prompt removal of the tick (see below).

Ticks represent an insidious danger to humans, since they are not readily detected when they first attach. Infants are particularly at risk. Ticks may attach in any body crevice or folds of skin, one of the most common places being behind the ear pinna.

Signs and Symptoms

Envenomation will always be a progressive process as the attached tick releases more saliva. The condition may worsen over several days, and even result in death caused by respiratory muscle paralysis. Earliest signs and symptoms are typically:

• Diplopia, photophobia, nystagmus, pupillary dilation
• Unsteady gait
• Lethargy
• Enlargement of regional lymph nodes
• Progressive paralysis

Treatment

Removal of the tick requires that the mouthparts not be left embedded in the skin. Simply gripping the body and pulling runs the risk of tearing the body from the embedded mouthparts and consequently injecting further venom. It has been suggested that insecticide causes the death of the animal and that the mouthparts, losing turgor, will no longer grip the skin.

More widely accepted is the use of curved forceps. Thes are used to grip the "head" of the animal as close as possible to the skin surface, and then levering it out.

Tetanus immunisation status should be checked and updated if necessary.

Additional clinical support required will depend on the nature of any paralysis. In severe cases, mechanical ventilation is required in order to redress respiritory muscle inadequacy.

Antivenom

Antivenom is indicated in cases where significant paralysis is evident. It has been shown to bring about complete resolution of paralysis even in cases of almost total involvement.

Tick antivenom supplied by CSL Ltd is canine in origin.