Northern Beaches Hospital – Mona Vale Tick First Aid

IN a world first, a northern beaches hospital has conducted research into the safest way to remove a tick.

First Aid for Tick removal provided in Simple Instruction First Aid training courses at the Dee Why RSL.

Dr Andy Ratchford, emergency director at Mona Vale Hospital who was involved in the study, said results showed killing the tick by freezing it while it was still embedded in the skin was the best course of action and could potentially save a life.

He said the research proves it was safer than using other methods such as pulling it out while still alive with tweezers or your fingertips.

“In general, we found that four out of five people who removed the ticks without killing them first suffered an allergic reaction, mostly it was a local reaction, but in some cases it was life-threatening,” Dr Ratchford said.

He said in comparison, only one out of ten patients who killed ticks in place by freezing them first, suffered a reaction.

“Anaphylaxis is potentially fatal. If you can remove the tick and decrease your chances of getting a reaction then that is important,” Dr Ratchford said.

Dr Ratchford said the advice was critical for those living on the northern beaches which was a known tick hotspot.

He said at Mona Vale Hospital they were seeing a year-on-year rise in tick related emergencies.

As well as dealing with minor reactions to tick bites, they were also seeing patients with cellulitis, tick typhus and those with life-threatening anaphylaxis caused by an allergy to a tick or to meat, brought on by a tick bite.

Allergy expert professor Sheryl van Nunen, who first linked ticks to meat allergies, estimates that more than 1000 people on the northern beaches have developed a meat allergy caused by a tick bite, while others have developed an allergy to ticks themselves.

Last December an Avalon dad told the Manly Daily how he was left fearing for his life when his throat started to close up and his eyes and tongue turned black, after his wife pulled out a tick in his neck with her fingertips.

Mona Vale doctors had to give 53-year-old wool trader Michael Kiernan three emergency shots of adrenaline to help him breathe in the terrifying ordeal. Despite being bitten many times by ticks, he had never had a reaction before. Now he has to carry an lifesaving Epipen in case he gets another tick.

Michael Kiernan was left fearing for his life after a tick bite turned his eyes and tongue black.
Dr Ratchford said they saw most of their tick patients between July and December, as that was when the adult female needs its last blood meal before producing offspring.

He said during this period around two per cent of all cases at Mona Vale’s emergency department were tick-related, which was high.

The study looked at 124 patients between July and December in 2016. He said that didn’t include everyone who came to emergency with a tick bite, but a large sample of patients with tick issues.

Dr Ratchford said those on the frontline of tick emergencies had been advising people to freeze not squeeze ticks for some time.

One of the ticks removed from patients at Mona Vale Hospital. Picture: Adam Yip
However, without research to back it up health authorities have been reluctant to promote the method.

“There’s so much conflicting evidence out there on how to remove ticks, it’s a minefield,” he said.

“This is the first research looking at the best way to remove ticks.”

He said he would be submitting his research to journals in the hope of getting the information out there.

HOW TO REMOVE A TICK:
1. For adult ticks, use a freezing agent, containing ether, such as WART-Off. Apply five presses of the treatment half a centimetre above the tick and wait for the tick to fall off. If it doesn’t, reapply. Seek medical help if a tick, dead or alive, doesn’t drop off.

2. For tiny ticks, such as larvae and nymphs, use a permethrin-based cream such as Lyeclear. Leave on for one to three hours and they should fall off.

3. For more information on how to prevent and remove ticks go to tiara.org.au.