Fight bites/human bites Flashcards
What is it called when teeth lacerate overyling skin and penetrate capsule of MCP joint druing kinetic impact?
Clenched Fist Injury (fight bite)
How long should you let your “fight bite” injury bleed after cleaing prior to intervention?
2 min. most interventions will push bacteria back into the joint.
Should you close fight bites?
no
First step in fight bite treatments
assess TDAP/HBV/HIV/immunization/testing status.
When should you administer tetanus prophylaxis?
if TDAP does was >5 years ago. or if <3 doses received.
if victim is positive for HIV/HBV/HCV consider prophylaxis for biter.
criteria for facial lacerations to be closed.
cosmetics are concern:
no s/s of infection
<24 hrs
MO notification
Patient counseled and consented regation outcome
*do not use tissue adhesive or staples
do human bites that do not break the skin or are superficial warrant prophylaxis?
no
ABX prophylaxis for fight bites
Amoxicillin-clauvanate 875/125mg PO BID x5 days
What antibiotics can you NOT use for fight bites/E.Corrodens
Cephalexin (keflex)
PRPs (dicloxacillin)
Macrolides (erythromycin and azithromycin)
presentation of fight bites
cellulitis. purulent drainage.
DEEP INFECTION:
pain with movement
out of proportion to exam
joint swelling
crepitus
systemic illness
Treatment for fight bites, uninfected.
Augmentin 875/125mg BID,3-5 days
(doxy or clinda if penicillin allergy)
circumstances that warrant parenteral ABX
> 100.5F, hypotension, tachy
deep infections
worsening after 48hrs
rapid progression of erythema
proximity to joint
Labs for fight bites
aerobic/anaerobic wound culture
CBC
ESR and CRP (if osteomyelitis)
Blood culture (systemic illness)
Imaging for fight bites
x ray to rule out foreign body or fracture
Circumstances with fight bite that warrant MEDADVICE
clenched fist wounds
facial lacerations
deep wounds
wounds with neurovascualr compromise
