36 - animal bites Flashcards Preview

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Flashcards in 36 - animal bites Deck (21)
1

parts of clinical assessment of bite

Hx
- circumstances
- Sx
- allergies
- tetanus
Phs
- damage
- type of wound
Xrays
- of possble bony
- skull film in children with head bites
cutures
- only if signs of infection

2

wound mgmt

most important part
- irrigate with saline syringe
- high risk for infection wounds should not be closed

3

5 risk risk wound factors

1. puntures
2. crush
3. over 12hours
4. hand or foot
5. near joints

4

3 patient factors

1. immunocompromised
2. >50
3. prosthetic joints or valves

5

what is penetrating injury in vicinity of MCP

human bite clenched fist until proven otherwise
- high potential for complications

6

Tx of clenched fist bite

- copious irrigation and debridement
- avoid sutures
- soak qid and keep elevated as often as possible
- if signs of infection, IV Abx

7

typical bite micro

poly
- staph and strep common

8

3 special bact. in bites

1. pasturella multocida
- gram neg rod
- 80% of cat and 50% of dog
- metastatic infections
- penicillin
2. capnocytophaga canimorsus
- gram neg rod
- normal in cats and dogs
- can cause overwhelming sepsis
- sens. to pen
3. eikenella corrodens
- common in human bites
- pen, cipro, clav

9

when to use prophylaxis

high risk btes
- full doses for 3-5 days

10

3 lines of Abx chouhce

1. amox-clav
2. 2nd gen ceph
- cefuroxime, cefaclor, cefoitin
3. combo
- clindamycin + flouro or doxy or septra

11

admission crit

- severe injury
- severe infection
- not responding to oral therapy
- immunocompromised
-

12

when to give tetanus

- all bites tetanus prone, so should give unless have had booster in last 5 years

13

main cause of rabies

bat bites

14

how is rabies transmitted

in saliva, and then travels up the senurons to brain

15

** what must be done in cases of possible rabies bite

report to public health

16

what is rabies postexposure prophylaxis

1. passive with rabies Ig 20IU/Kg
2. active in series of 4 on days 0,3,7,14
3. if immunocompromized, should get a day 28 as well
- vaccine to deltoid
- RIG into and around wound
if previously immunized, should het 2 doses on day 0 and 3

17

Tx for low risk domestic

- observe animal 10 days
- Tx at first sign of rabies

18

T for wild animal

Tx as rabies unless can see animal

19

Tx for livsetock or small animals

- consult public health
- err on side of caution

20

when to def. give rabies

1. head or neck bites
2. steroid or immunocompromised
3. high risk region by dog or cat

21

when to give for bats

- bite or scratch
- direct contact with bat