Bites/stings and creepy things- Jaynstein

Question 1

Bites: what is needed for hx taking?

Answer 1

Is the animal known or unknown? UTD on shots?

What breed of animal?

Time of bite

Presence of comorbitities – DM, immunocomp

Tetanus hx (q10years wo incident, every 5 yrs with incident)

Question 2

Mammalian bites: wound management

Answer 2

• Prevention of infection is the goal

- eval for foreign bodies** (teeth/clothing material)

Question 3

___% of dog wounds get infected VS ___% of cat wounds

Answer 3

• 5%- dogs

- up to 50%- cats

Question 4

Infection Risks:

list Ex’s

Answer 4

• DM** & immunocompromised
• Bite to HAND or foot
• Extremity bite in a pt with poor vascular supply
• Bite near hardware
• Crush injury or multiple puncture wounds
• **Cat bite
• Delayed presentation – >12hr extremity, 24hr face

Question 5

Bites will include flora from _____ and _____

Answer 5

-from the animal!
AND
-from human skin flora– DONT FORGET staph and strep**

Question 6

What is the MC bacterial organism from both dog and cat bites? (majority are polymicrobial)

Answer 6

*pasteurella

Question 7

What is another organism that is specific to dog bites, that is rare but has a VERY high mortality?

Answer 7

*Capnocytophaga

Question 8

“Pt presented with a dog bite and was started on appropriate ABx. The wound progressed within 24 hours and Pt is now systemically ill. “What dx is this?

Answer 8

**Capnocytophaga- rare organism from dog bite

Question 9

T/F: cat teeth can penetrate bones/joints

Answer 9

T

Question 10

T/F: Cat bites can cause septic arthritis, osteomyelitis and tenosynovitis

Answer 10

T!

-**Pasteurella multocida usually within 12 hours

Question 11

What should you document for a cat bite?

Answer 11

Document # of punctures, drainage, surrounding erythema, and complete NV exam with CMS

Question 12

“Pt presents after a hand injury with fusiform** swelling. Pain w/ passive ROM”

Answer 12

dx: Tenosynovitis