What do they do in the hospital when a tick bites? - briefly
In the emergency department, clinicians carefully remove the tick, record the duration of attachment, and assess for immediate signs of infection. They may prescribe a brief course of doxycycline or another antibiotic for prophylaxis and schedule follow‑up testing as indicated.
What do they do in the hospital when a tick bites? - in detail
When a patient presents after a tick attachment, clinicians follow a systematic protocol that begins with a focused history and physical examination. The interview records the geographic location of exposure, the estimated time the tick remained attached, and any recent symptoms such as fever, rash, or joint pain. The examination identifies the tick, notes its attachment site, assesses engorgement, and documents its species when possible.
The removal procedure uses fine‑point tweezers to grasp the tick as close to the skin as possible, applying steady upward pressure without twisting. After extraction, the bite area is cleansed with antiseptic, and the tick is placed in a labeled container for laboratory identification if indicated. Documentation includes the date of removal, the tick’s developmental stage, and the degree of engorgement.
Risk assessment follows three criteria: (1) tick species known to transmit Borrelia burgdorferi, (2) attachment duration of at least 36 hours, and (3) residence or travel in an area where Lyme disease is endemic. If all criteria are met, a single dose of oral doxycycline (200 mg for adults, weight‑adjusted for children) is administered within 72 hours of removal as prophylaxis.
When clinical signs suggest infection, laboratory evaluation proceeds. Initial tests include a complete blood count, liver‑function panel, and serologic assays for Lyme disease (ELISA followed by Western blot if positive). Additional panels target rickettsial diseases, anaplasmosis, or babesiosis based on regional prevalence and symptomatology.
Therapeutic regimens depend on the identified pathogen and disease stage. Early Lyme disease receives oral doxycycline (100 mg twice daily for 10–21 days) or amoxicillin for pregnant patients and young children. Severe manifestations—such as meningitis, carditis, or high‑grade fever—warrant intravenous doxycycline or ceftriaxone, continuous monitoring, and supportive care. Rocky‑Mountain spotted fever is treated with doxycycline 100 mg twice daily for at least 7 days, regardless of age.
Patients requiring hospitalization are observed for complications: cardiac conduction abnormalities, neurologic deficits, or persistent fever. Intravenous fluids, antipyretics, and symptomatic management are provided as needed. Discharge planning includes written instructions on proper tick removal, warning signs that merit immediate medical attention, and a scheduled follow‑up visit within 2–4 weeks to reassess serologic results and clinical status.
The overall approach combines prompt mechanical removal, evidence‑based prophylaxis, targeted diagnostics, and appropriate antimicrobial therapy, ensuring that tick‑borne infections are identified early and treated effectively.