Insect Stings, Reptile and Animal Bites Lecture Powerpoint Flashcards
Most common pathogens involved in human bites from the oral flora (2) and the patient’s skin (2)
- Eikenlla
- Group A strep
- staph
- strep
Occlusal bites
Semicircular or oval, skin may or may not be intact, more common on fingers, hands, or arms
Clenched fist bites
Injuries that most often occur as lacerations in the 3rd or 4th MCPs or PIPs of dominant hand and highly prone to infection because often ignored, occur most often when clenched fist of person strikes teeth of another
Important animal flora pathogens in bites (1)
-pasteurella
Infections are more common with what type of animal bite?
Cat bites
Complications of bites (4)
- cellulitis
- septic arthritis
- osteomyelitis
- sepsis
Examining the full range of motion of extremities is particularly important in what kind of bite injury?
Clenched fist injuries
Lab studies for bite injuries (3)
- X ray for clenched fist injuries or concern for foreign body
- MRI/CT if concern for deep infection
- wound culture if infection
Treatment for bite wound (4)
- cleansing, irrigation, dressing, daily eval for infection, foreign body removal
- most bites should be left to heal by secondary intention (left open) due to high risk of infection
- augmentin prophylaxis (almost everyone)
- IV if signs of systemic illness
Rabies post exposure prophylaxis
If high risk wild animal then need it, if stray dog will need it, if low risk animal or vaccination status of animal is known then do not, can monitor animal status to see if they die within 10-14 days, if patient never had exposure before need immunoglobin and vaccine (0, 3, 7, 14, and 28 if immunocompromised), if patient has then need vaccine only on day 0 and 3
Tetanus prophylaxis
Indicated in nearly all wounds, in clean and minor wounds don’t need human IG but all other do, if <3 doses or unknown tetanus status then need tetanus toxoid containing vaccine, (Dtap if <7, Td, Tdap), if >3 doses only need if last dose given >10 years ago
Clinical manifestations of crotalinae snake bites (5)
- fang marks
- localized pain
- coagulopathy
- N/V/D, weakness, diaphoresis or chills
- neurotoxicity
Crotalinae snake bites treatment (4)
- local wound care, remove any restrictive devices and clothing
- supportive and symptomatic care (fasciotomy for compartment syndrome for example)
- severe cases or face/neck involvement give antivenom FabAV or Fab2AV
- tetanus prophylaxis
- treatment can stop once see regression in bite (symptoms plus edema and erythema decrease)
Coral snake bite symptoms (5)
- tremors
- salivation
- paralysis
- dysphagia
- seizures
Coral snake bite treatment options (2)
- 3 vials of antivenom
- tetanus prophylaxis
