Insects, Stings, Reptile Bites Flashcards
human oral flora
Eikenella
Group A Strep
human skin flora
staphylococci and streptococci
animal flora pathogen (dogs and cats)
Pasteurella spp. – 50% dogs wounds, 75% cat wounds
are infections more common in dog or cat bites
cat
signs of superficial infection
tenderness, erythema, swelling, warmth, purulence, lymphangitis, fluctuance (abscess)
signs of deep infection
superficial +
persistent pain, pain with passive ROM, pain out of proportion, crepitus, joint swelling, systemic illness (fever, hemodynamic instability), persistent signs of infections despite intervention
what should you always do for clenched first injuries in the PE
test for full range of motion
what type of closure do you need for infected looking and noninfected looking bites
left to heal by secondary intention (left open) except in facial wounds
first line tx for noninfected bite
Amoxicillin-clavulanate 875/125mg BID
first line tx for infected looking bite
Ampicillin-sulbactam
Piperacillin-tazobactam
Ceftriaxone PLUS Metronidazole
OR Clindamycin
abx prophylaxis indications
Those undergoing primary closure or surgical repair
Hand, face, or genitals OR close proximity to bone or joint
Area of underlying venous or lymphatic compromise (e.g.
vascular grafts, etc.)
Immunocompromised
Associated with a crush injury
incubation of rabies
2 wks to 45 days
vaccine schedule for rabies and no hx of vaccine
RIG: 20U/kg; infiltrate around the wound then rest given IM
Vaccine: 1 mL IM (deltoid) given on days 0, 3, 7, 14, 28*
*add day 28 If immunosuppressed
vaccine schedule with hx of vaccine for rabies
days 0 and 3
should you use ice for Crotalinae Bite
NO
