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http://www.integrative-healthcare.org/mt/archives/2009/06/is_a_tick_buryi.html?eml=mpu64b

June 15, 2009
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Is a Tick Burying Itself in Your Client's Skin?

Because massage therapists may see parts of their clients' bodies that others rarely see, they might be the first person to spy a tick. If you are a practicing bodyworker, you ought to make sure you know what steps to take if you see a tick on your client.

by Nicole Cutler, L.Ac.

Detecting and removing ticks may be far beyond what a massage therapist might have anticipated in his/her job description. However, bodyworkers may be the only person to see certain parts of their clients' bodies; and thus be the first to glimpse one of these blood-feeding parasites. Massage therapists who educate themselves on what to do in the presence of a tick are best prepared to help this arthropod's victim - whether it is a family member or one of their own clients.

A Bit About Ticks
Because ticks are so common, people who spend any time in the outdoors will eventually encounter one. After attaching themselves to their host, a tick feeds on its host's blood. Unfortunately, ticks can acquire diseases form one host and pass it to another through their saliva. With more than 800 species throughout the world, ticks are the leading carriers of diseases to humans in the United States, second only to mosquitoes worldwide. They are responsible for carrying such diseases as:

· Rocky Mountain spotted fever
· Lyme disease
· Babesiosis (Texas fever)
· Ehrlichiosis
· Tularemia
· Colorado tick fever
· Powassan (a form of encephalitis)

Research conducted at Ohio State University indicates that transmission of disease begins approximately 24 hours after a tick begins feeding. However, most infected ticks usually don't spread the disease until they've been attached for at least 36 hours. Experts on disease transmission agree that the longer a tick feeds the greater potential for it to transmit an infection. Thus, anyone participating in outdoor activities, or who interacts with an outdoor pet, is advised to regularly survey his/her body for ticks.

Tick Removal
Since the longer a tick stays attached to someone the more likely they are to become infected with a disease, their prompt removal is imperative. Folkloric descriptions for the best way to remove a tick have circulated for years, creating confusion for those spying one of these bloodsuckers. Although some tick removal methods involve using soap, petroleum jelly, nail polish or a match, experts warn that these approaches can increase the amount of saliva the tick transfers to its host. Experts suggest the following protocol for tick removal:

1. Tweezers - Use fine point tweezers to grasp the tick at the place of attachment, as close to the skin as possible.

2. Pull - Gently pull the tick straight out. Avoid crushing the tick's body and do not be alarmed if the tick's mouthparts remain in the skin. Once the mouthparts are removed from the rest of the tick, it can no longer transmit bacteria. If the tick is accidentally crushed, clean the skin with soap and warm water or alcohol.

3. Save - Place the tick in a small vial or sealable bag with a damp paper towel to prevent it from dehydrating. If warranted by the victim's physician, protecting the tick from dehydration aids in its identification.

4. Clean - Wash your hands, disinfect the tweezers and cleanse the bite site.

Ethics of Tick Removal for Bodyworkers
A person receiving a massage may be unaware of a tick feeding on him/her. Especially if a client has recently been in a wooded area and the tick is hidden from his/her line of vision, a massage therapist's routine could be interrupted upon spotting one of these arthropods.

Since a client's well being should be a bodyworker's top priority, attached ticks cannot be ignored. However, tick removal is not defined within a massage therapist's scope of practice. Despite this omission, longer lengths of time increases the likelihood a feeding tick will transmit illness. Therefore, bodyworkers must take appropriate steps to help remove the tick from clients.

The following six steps are intended to guide a bodyworker who finds a tick on his/her client:

1. Remain Calm - Getting freaked out does not benefit you or your client.

2. Disclose the Problem - Calmly inform your client that you see a tick.

3. Ask Permission - Ask your client for his/her permission to remove the tick. If s/he seems hesitant, inform him/her of the importance of timeliness.

4. Remove Tick - Follow the tick removal instructions described above.

5. Avoid Area - After cleaning the bite site, avoid massage therapy in that affected area.

6. Advise - After your session, give the tick to your client and suggest s/he discuss future steps (tick identification and/or prophylactic medication) with his/her physician.

Even if the thought of seeing or removing a tick from your client makes you uneasy, all health professionals must be equipped for this possibility. Swift removal of a tick may prevent your client from becoming infected with a potentially serious disease. If you do find yourself in this situation and must remove a tick during a massage session, you will have provided a tremendous service to your client - and s/he will be forever thankful.

Ethics of Tick Removal for Bodyworkers
A person receiving a massage may be unaware of a tick feeding on him/her. Especially if a client has recently been in a wooded area and the tick is hidden from his/her line of vision, a massage therapist's routine could be interrupted upon spotting one of these arthropods.

Since a client's well being should be a bodyworker's top priority, attached ticks cannot be ignored. However, tick removal is not defined within a massage therapist's scope of practice. Despite this omission, longer lengths of time increases the likelihood a feeding tick will transmit illness. Therefore, bodyworkers must take appropriate steps to help remove the tick from clients.


I was taught that removing a tick is indeed overstepping legal boundaries, and that if there wasn't an esthetician available I should just work around it, then inform the client as he was leaving. I like this version better, about asking permission to remove it.  Legally, though, I wonder what my liability would be for removing it.

Other bodyworkers, speak up please -- which way were you taught and which way would you handle it?

(I know for a fact I'd rather have my MT take the freaking thing off me!)

Adopt one today!Adopt one today!Adopt one today!Adopt one today!
And a scroll
 

Date: 2009-07-01 09:21 pm (UTC)
From: [identity profile] rowangolightly.livejournal.com
I most definitely would want the tick removed. As for keeping it, hells no, I kill it immediately.

Date: 2009-07-01 09:30 pm (UTC)
From: [identity profile] 5rings.livejournal.com
Yes indeed. I might, as a patient, ask about the location and size. But it would be my guess that if the darned thing could be readily got to by me, I'd have found it already. So, yeah, I'd accept the help getting it off in a heartbeat. And I believe in tweezers or even (if I'm doing it) fingernails.

Burning, etc. Bah. Unnecessary.

Maybe in future they'll add it to the coursework.

Date: 2009-07-01 10:09 pm (UTC)
From: [identity profile] diermuid.livejournal.com
Locally, we use tweezers and save the tick so that it can be sent 'somewhere' for testing, but that's a Boy Scout policy.

Date: 2009-07-01 09:30 pm (UTC)
From: [identity profile] softpaw.livejournal.com
What the queen said.

Date: 2009-07-01 09:30 pm (UTC)
From: [identity profile] brujah.livejournal.com
As a client, I'd want to be told and I'd want the damned thing removed. >_

Date: 2009-07-01 09:33 pm (UTC)
From: [identity profile] apocalypticbob.livejournal.com
I would definitely want to be told and have it removed if possible, if the body worker was comfortable with doing so. The massage would be over as soon as I was told unless the bodyworker could remove it, because I would want to get it off as soon as possible and I wouldn't be able to relax until it was gone, so the remainder of the massage would be a moot point. If a MT removed a tick from me, my tip would increase exponentially, as they would have gone above and beyond, as far as I'm concerned.

Also....EWWWWWW!!! God, I hate ticks!

Date: 2009-07-01 09:37 pm (UTC)
From: [identity profile] zianuray.livejournal.com
OK, 6 -0 in favor of "getitoffgetitoffgetitOFF!"

For anyone wondering, that was my default anyhow -- my teacher is smart, but there's times to make your own decisions!
Edited Date: 2009-07-01 09:39 pm (UTC)

Date: 2009-07-01 09:37 pm (UTC)
From: [identity profile] bleuberi21.livejournal.com
I would much prefer them take it off than let it sit there longer!

Date: 2009-07-01 09:58 pm (UTC)
From: [identity profile] dianthus-pink.livejournal.com
I'd totally want it taken off me. Preferably before telling me about it. *shudder* I would want the tick plopped in something so I could take it to a doctor and get it tested for disease.

Date: 2009-07-01 10:07 pm (UTC)
From: [identity profile] diermuid.livejournal.com
What the f-ck?

If a person comes in with a compound fracture are you supposed to just mention it to them when they're leaving? "Oh, btw, you may want to get that looked at." I agree if you're not comfortable with tick-picking, but legal boundries??

I hate 'legal boundries' that just make the world a more screwed up place to be. As a scout leader, I have to take ticks off kids all the time, bag 'em and tag 'em. No training provided.

I realize I may be ranting against a side-point... just in a ranty mood today. Maybe I need a massage. ::grin::

Date: 2009-07-01 10:12 pm (UTC)
From: [identity profile] manifestress.livejournal.com
This is fascinating as I was NEVER taught anything at all about this - it never came up in all the many trainings I've been in.

Date: 2009-07-01 10:25 pm (UTC)
From: [identity profile] zianuray.livejournal.com
It was covered in our "ethics" under "what we can't do" -- at least in Missouri! I realize other states may have different rules.

Date: 2009-07-01 10:18 pm (UTC)
From: [identity profile] 5rings.livejournal.com
See, the kind of comment I might wait, were I a therapist to make until after a massage is over might be something like:

Hmm... Do you know about that mole? I'm a bit concerned as to it's color and irregular boundary. I'm not an expert, but you might consider showing it to someone who is...

Date: 2009-07-01 10:27 pm (UTC)
From: [identity profile] zianuray.livejournal.com
Yeah, the mole I can't do anything about. A tick, well, I CAN. Even if I'm not SUPPOSED to. (And like I said, sometimes there's good reasons to bend rules!)

Date: 2009-07-01 11:13 pm (UTC)
From: [identity profile] cattinsley.livejournal.com
As far as I know Estheticians cannot remove them either...any more than we can lance open an impaction. I am a paramedical esthetican, however I have never come upon this question.

Date: 2009-07-01 11:17 pm (UTC)
From: [identity profile] zianuray.livejournal.com
I was taught that any esty who may do comedo removal may, with gloves and properly sterilized tweezers, remove a tick. That said, I'll believe you, who have taken the training, over someone (my teacher) who has not!

Date: 2009-07-02 12:18 am (UTC)
From: [identity profile] thebruce.livejournal.com
You bet, get it off, and now, then continue the massage :)

I found one in my navel while working from home on Tuesday. From the looks of things, he'd been there a while. Ew. Fortunately he came off with no difficulty or complications.

Date: 2009-07-02 12:45 am (UTC)
ext_3038: Red Panda with the captain "Oh Hai!" (Default)
From: [identity profile] triadruid.livejournal.com
Tell the client it's there, and ask them if they want it removed. Chances are they'll either say yes, or get up to do it themselves. The few who don't are probably the reason that rule is there.

DON'T get yourself in trouble over this. I bet if you say "I can remove it, but it's not part of the massage therapy" or words to that effect, it'd probably protect you, unless the law is more specific than I expect.

Date: 2009-07-02 01:18 am (UTC)
From: [identity profile] barnhengemama.livejournal.com
Definately ask. This never came up in my ehtics coursework either, though.

I'm first aid trained, if a client fell in my room or something else like that, I'd have to help them. I think a tick falls under that category. Especially if its in a hard to reach place. My state is a "black state" for Lyme disease, so it's serious business to remove, bag, and tag it.

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