This document discusses Lyme disease, including the black-legged tick that transmits the bacteria Borrelia burgdorferi, which causes Lyme disease. It notes that the risk of transmission increases the longer the tick is attached, reaching 79% at 72 hours and 94% at 96 hours. It describes symptoms of Lyme disease and two-tiered diagnostic testing involving ELISA and Western Blot. The document concludes with several case studies presenting different patient scenarios involving potential Lyme disease.

1. Lyme DiseaseNichole C. Martin RN, BSN, CEN, CPEN

2. Black-legged tick (Ixodesscapularis)a.k.a. Deer tick

3. Life cycle of a tick

4. Transmission of B.burgdorferi

5. Transmission of B.burgdorferi

6. Transmission of B.burgdorferi Risk of transmission of B. burgdorferi from an infected tick increases with the amount of time the tick is embedded 24 hours - 0% 48 hours - 12% 72 hours - 79% 96 hours - 94%

7. Removal

8. Symptoms

9. Symptoms

10. Symptoms

11. Two Tiered Testing

12. Diagnostic Testing

13. Treatment

14. Other concerns…

15. Case Studies 4 year-old healthy child that is asymptomatic comes in with mother who states the child is always playing in their field so she would like a Lyme disease test

16. Case Studies 24 year-old female comes in with tick embedded behind ear, this is the tick:

17. Case Studies 34 year old male comes in for yearly physical. Works as a forester and states from spring to fall he pulls multiple ticks off almost daily, states he usually finds them before they embed. Occasionally finds both dog and deer ticks embedded but never engorged, has gotten red rashes around bites before, denies myalgias except the occasional backache

18. Case Studies 54 year old female comes in stating fatigue, generalized weakness, and diffuse arthralgias for the past 3-4 years, states “I looked online and I think I have Lyme’s”

19. Case Studies 63 year old female presents to the ED via EMS with complaint of general malaise for past 3 weeks, body aches for past week and syncope today, EKG shows this:

20. The End