Yellow - Bite wounds Flashcards
How should you clean a bite wound?
- Irrigate wound with tap water or NS using a 19 gauge needle and syringe
- Clean surrounding skin with 1% povidone-iodine
- Debride and devitalize tissue
- Irrigation with penicillin or cephalosporin containing fluid may better prevent infection
How should hand lacerations be healed?
- By secondary intent
- Deeper wounds to the hand or infected bites presenting after 24 hours may require exploration and debridements in the OR with IV abx.
- Tendon and nerve injuries are best managed with delayed repair
- Puncture wounds should not be sutured
What is the usual bacterial source and treatment for cat bites?
- Bacteria: Pasteurella multocida
- Treatment: penicillin + dicloxacillin
What are the most common bacteria in human bites?
- Streptococcus
- Staphylococcus aureus
- H. parainfluenza
- Klebsiella pneumoniae
- Eikenella bacteroides
- Fusobacterium
- Anaerobic cocci (peptostreptococci)
What drug(s) is used to treat human bite wounds?
- 2nd or 3rd generation cephalosporins
OR - Dicloxacillin + ampicillin
What drug(s) is used to treat dog bites?
- Usually nothing unless the bite is to the hand (then dicloxacillin or cephalexin)
What is the tx alternative for dog-cat bites with a penicillin allergy?
- TMP-SMX
What drug(s) can be used for all bite sources?
- Cefuroxime–>2nd gen. cephalosporin
- Clavulin
What should you do with a bite concerning for rabies?
- Wash with soap?
- Irrigate with povidone-iodine or benzalkonium chloride
- Leave wound open to air
PPE Tx = antirabies serum + vaccine course + local wound tx
Which type of animals are always considered rabid?
- Wild carnivores
What type of animal bites warrant a call to the local health unit for advice?
- Domestic animals
- Rodents
- Lagomorphs (rabbits, hares)
What is the rabies recommendation for a bite from a domestic dog?
If it appears healthy then observe the animal for 10 days for signs of rabid behaviour
What is the dosing protocol for passive rabies immunization?
- 20 IU/kg of rabies Ig
- Give 1/2 around site and 1/2 IM
What is the dosing protocol for active rabies immunization?
Active immunization of days 0 and 3 (booster)
What is the dosing protocol for those who have already received rabies pre-exposure immunization?
Active immunization of days 0 and 3 (booster)
