Immediate treatment of the woundThe local treatment is very important and is intended to remove and neutralize the biting animal’s saliva. Wash the location thoroughly and, as soon as possible, wash all of the area exposed with running water and soap. Do this even if several hours have passed since the bite occurred. Disinfect the area with alcohol 70% or with iodine tincture.
Treatment at a clinic
- Anti-Tetanus shot
Prevention of tetanus after the injury is based on treating the wound as soon as possible and assessment of the need for an active immunization with or without a passive immunization (taking into consideration the patient’s tetanus immunization history and the nature of the wound on the one hand, and the timing of the delivery of the local treatment to the wound on the other). A wound resulting from a dog bite or from being bitten by any other animal is treated as a wound from any other cause.
- Antibiotic treatment
The antibiotic treatment is the responsibility of the emergency medicine ward doctor or the doctor at the clinic. It is recommended to administer antibiotic treatment for 3-5 days if the bite penetrated the skin or if it is deep and there are signs of local inflammation. The doctor must decide on further treatment depending on the state of the wound. The common instigators in these wounds are:
pasteurella, staphylococcal aureus
multocida, anaerobes gram negative
The medicine of choice is augmentin. The bite can also be treated with clindamycin with quinolones (ciprofloxacin or floxacin).
Emergency room treatment
- Local treatment of the wound depending on the type of wound.
- It is recommended that immediate stitching of the wound be avoided, unless it is a facial wound. If the doctor decides to go ahead and stitch the wound anyway, first contact the Health Bureau doctor to find out whether there is a need to administer a passive immunization. If so, it must be applied to the wound and the surrounding areas before stitching. The stitching must be done only after clearing the wound; the stitching must be limited to seaming the lips of the wound only.
- Consider prescribing antibiotic treatment.
- Deliver an anti-tetanus shot if needed.
- The doctor in the emergency medicine ward should consult over the phone with the Health Bureau duty doctor as to whether it is necessary to administer preventive rabies shots in any event.
- Refer every such patient to the Health Bureau for further treatment. If the bureau is closed, refer the patient to the Health Bureau on the following business day.
