A leech can be removed in a number of ways depending on its size and location.
Basic methods:
(1) topical
(2) injection directly into the leech
(3) physical
(4) electrical
Topical treatments have included:
(1) dilute chloroform
(2) turpentine oil
(3) 5% cocaine
(4) hypertonic saline
(5) topical anesthetic
Injection (requires a leech of sufficient size to avoid accidental injection into the patient):
(1) 4% lidcocaine
Physical:
(1) grasping with forceps (works better on a mucosal surface compared to skin)
Electrical:
(1) bipolar electric shock (being careful not to shock the patient)
A combination of methods can be used such as topical anesthesia followed by forceps removal.
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Specialty: Emergency Medicine, Critical Care