36 - animal bites Flashcards
1
Q
parts of clinical assessment of bite
A
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
Q
wound mgmt
A
most important part
- irrigate with saline syringe
- high risk for infection wounds should not be closed
3
Q
5 risk risk wound factors
A
- puntures
- crush
- over 12hours
- hand or foot
- near joints
4
Q
3 patient factors
A
- immunocompromised
- > 50
- prosthetic joints or valves
5
Q
what is penetrating injury in vicinity of MCP
A
human bite clenched fist until proven otherwise
- high potential for complications
6
Q
Tx of clenched fist bite
A
- copious irrigation and debridement
- avoid sutures
- soak qid and keep elevated as often as possible
- if signs of infection, IV Abx
7
Q
typical bite micro
A
poly
- staph and strep common
8
Q
3 special bact. in bites
A
- pasturella multocida
- gram neg rod
- 80% of cat and 50% of dog
- metastatic infections
- penicillin - capnocytophaga canimorsus
- gram neg rod
- normal in cats and dogs
- can cause overwhelming sepsis
- sens. to pen - eikenella corrodens
- common in human bites
- pen, cipro, clav
9
Q
when to use prophylaxis
A
high risk btes
- full doses for 3-5 days
10
Q
3 lines of Abx chouhce
A
- amox-clav
- 2nd gen ceph
- cefuroxime, cefaclor, cefoitin - combo
- clindamycin + flouro or doxy or septra
11
Q
admission crit
A
- severe injury
- severe infection
- not responding to oral therapy
- ## immunocompromised
12
Q
when to give tetanus
A
- all bites tetanus prone, so should give unless have had booster in last 5 years
13
Q
main cause of rabies
A
bat bites
14
Q
how is rabies transmitted
A
in saliva, and then travels up the senurons to brain
15
Q
** what must be done in cases of possible rabies bite
A
report to public health
