Animal Bites and Tetanus

Question 1

Rabies Category I

feeding or touching an animal
licking of intact skin
exposure to patients w/ signs of rabies or sharing or eating or drinking utensils
casual contact w/ patient w/ signs of rabies

Answer 1

No vaccine or RIG needed

Question 2

Rabies Category II

nibbling or nipping of uncovered skin w/ bruising
minor scratches or abrasions w/o bleeding (includes wounds that induced to bleed)
licks on broken skin

Answer 2

Start rabies vaccine immediately (Active Immunization)

1. COMPLETE REGIMEN UNTIL DAY 28/30 IF
	was proven in the lab to have rabies
	w/ signs or symptoms of rabies
	died or was killed w/o lab testing
	cannot be observed for 14 days

2. MAY OMIT DAY 28/30 DOSE IF
   animal is alive AND remains healthy after 14 day observation period
   animal under observation died w/n 14 days but had no signs of rabies and IFAT negative

Question 3

Rabies Category III

transdermal bites or scratches (puncture wounds, lacerations and abrasions)
contamination of mucous with saliva

exposure to rabies patient through bites, contamination of mucous membranes or open skin lesions w/ body fluids (except blood or feces) through splattering, mouth to moth resuscitation, licks of eyes, lips, vulva, sexual activity, exchanging kisses on mouth or other direct mucous membrane contact w/ saliva

handling of infected carcass or ingestion of raw infected meat

all category II exposures on head and neck areas

does not include sharing of food, drinks or utensils and casual contact w/ rabid patient

Answer 3

Start rabies vaccine and RIG immediately (active and passive immunization)

1. COMPLETE REGIMEN UNTIL DAY 28/30 IF
	was proven in the lab to have rabies
	w/ signs or symptoms of rabies
	died or was killed w/o lab testing
	cannot be observed for 14 days

2. MAY OMIT DAY 28/30 DOSE IF
   animal is alive AND remains healthy after 14 day observation period
   animal under observation died w/n 14 days but had no signs of rabies and IFAT negative

Question 4

Immunization Therapy of Rabies

Answer 4

Day 0: Purified Verocell Rabies Vaccine (PVRV) and RIG
Day 3,7,14,30 - PVRV

Active Immunization
PVRV 0.5 mL/vial
PDEV 1 mL/vial

IM schedule (deltoid) - day 0,3,7,14,30

Passive Immunization
HRIG 20 IU/kg
ERIG 40 IU/kg

first dose of vaccine should be inoculated at the same time as the IG but in different part of 
	the body
half the dose  should infiltrate the wound and the other half given IM

Question 5

Jackson Zones of Burn Injury

occupies the CENTRAL area
MOST SEVERE BURN INJURY
NO CAPILLARY BLOOD FLOW

Answer 5

Zone of Coagulation

Question 6

Jackson Zones of Burn Injury

surrounds the zone of coagulation
area of MODERATE injury
SLUGGISH capillary blood flow
SALVAGEABLE by appropriate resuscitation

Answer 6

Zone of Stasis