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Management of Mammalian Bites in Emergency Setting


Nowadays, animal bites are common (Rothe, Tsokos, & Handrick, 2015). Consequently, treating them promptly is essential, as, otherwise, it may lead to health complications. The primary goal of this paper is to describe the initial treatment, determine the most effective choices of antibiotics, and define follow-up care. In the end, it is essential to identify the cases when suturing of wounds is appropriate.

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Initial Treatment

Firstly, it is essential to determine the procedures that have to be performed in the emergency setting. It is only rational to review medical history and past treatment only if a patient is in stable condition (Rasmussen, Landon, Powell, & Brown, 2017). In this instance, asking him/her about different chronic illnesses and bite circumstances can help define the most appropriate action plan and treatment. Nevertheless, if the patient is unstable, it is of paramount importance to stabilize his/her condition by ensuring sufficient air circulation and stopping bleeding (Rasmussen et al., 2017). Only after that, it will be reasonable to conduct a subjective assessment.

After the stabilization of the patient, it is vital to assess the severity of the wound, classify it, determine its key features (length, size, and effect on motion), and evaluate if there are any symptoms of infection (Rasmussen et al., 2017). Along with that, it is of high importance to disinfect the wound quickly, as, skipping this procedure, may lead to adverse health consequences. This phase includes the following steps: 1) disinfect the area around the wound with 1% povidone-iodine; 2) treat the wound itself with 0.9% sodium chloride solution (use catheter to clean the wound profoundly); and 3) inspect the wound and remove any foreign objects and debris from it (Rasmussen et al., 2017). In case of other complications and after these steps, the patient has to be taken to the hospital immediately.

Choices of Antibiotics

Apart from the actions mentioned above, the role of antibiotics cannot be underestimated, as the wounds from mammalian bites are vulnerable to infections (Evgeniou, Markenson, Iyer, & Armstrong, 2013; Rothe et al., 2015). Some of the studies indicate that antibiotic therapy is not compulsory, especially, if the wound is insignificant. However, it is critical to undergo this therapy in the cases such as 1) deep bites; 2) cat bites; 3) bite’s location close to the genitals, face, and joints; and 4) severe condition of the injuries (Rasmussen et al., 2017). Consequently, if the antibiotic treatment is necessary, one of the possibilities is amoxicillin/clavulanate (a three-to-five-day course) (Rasmussen et al., 2017). If the patient is allergic to the components of the indicated antibiotics, other options are clindamycin plus ciprofloxacin, clindamycin plus sulfamethoxazole-trimethoprim, and azithromycin (Rasmussen et al., 2017). This treatment is only applicable to the patients with the cases stated above. In severe situations, hospitalization and usage of IV antibiotics may be necessary.

Follow-up Care

Thus, in the case of mammalian bites, follow-up treatment is a requirement, as it is of critical significance to monitor any changes in the condition of the patient. Thus, before prescribing particular antibiotics, it is necessary to conduct a diversity of tests to determine any specifics and complications such as bone injuries (Rasmussen et al., 2017). It may be essential to evaluate the flora of the bite to determine the nature of the infection, as saliva of different animals contains various bacteria. For example, dog’s one may have Moraxella, Enterobacter, and Staphylococcus (Auerbach et al., 2016). A combination of these factors along with the analysis of the patient’s medical history help prescribe the right antibiotics and determine the necessity of vaccination from tetanus and rabies, as it may not be required in a limited number of cases.

In turn, if the wound affects the functioning of other systems, referring to other specialists may be a necessity, as surgery may be required (Rasmussen et al., 2017). Thus, after prescribing the treatment, the number and frequency of follow-up visits are highly dependent on the severity of the wound and the condition of the patient. For example, if a patient has a wound will a low risk of infection, only one visit in two days may be required (Auerbach, Cushing, & Harris, 2016). In other cases, more visits may be compulsory, especially, if any infection is present. Lastly, follow-up care requires covering aspects such as patient education, as it is of high significance to explain the current condition, importance of following the prescription, ways of treating the wound, and various prevention strategies (Bastable, 2016; Murtagh, 2016). It will help the patient to recover from emotional stress, deal with mental pressure, and avoid wound infection and accompanying complications.

Conclusion: Suturing of Wounds

Previous sections provided a profound analysis of examination, treatment, usage of antibiotics, and follow-up care. Nevertheless, another critical point to discuss is suturing of wounds. This procedure is dependent on the condition of the wound (Rasmussen et al., 2017). In the majority of the cases, suturing is required for cosmetic reasons or to prevent the spread of infection in wounds occurred less than 12 hours ago. To deal with these issues, subcutaneous suturing has to be utilized, as doing it differently may lead to inflammation of tissues and other adverse consequences (Rasmussen et al., 2017). Thus, here is the list of situations when suturing is forbidden: 1) crush injuries and puncture wounds; 2) wounds of legs or arms occurred more than 12 hours ago; 3) face wounds that took place more than 24 hours ago; 4) human bites of joints; and 5) bite wounds among patients with immune system’s issues. To summarize, considering all specifics mentioned above is of extreme importance, as any wrong actions will lead to adverse consequences.

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Auerbach, P., Cushing, T., & Harris, N. (2016). Auerbach’s wilderness medicine. Amsterdam, Netherlands: Elsevier Health Sciences.

Bastable, S. (2016). Essentials of patient education. Burlington, MA: Jones & Bartlett Publishers.

Evgeniou, E., Markenson, D., Iyer, S., & Armstrong, A. (2013). The management of animal bites in the United Kingdom. Eplasty, 13(1), 27.

Murtagh, J. (2016). Murtagh’s patient education. New York, NY: McGraw-Hill Education.

Rasmussen, D., Landon, A., Powell, J., & Brown, G. (2017). Evaluating and treating mammalian bites. JAAPA, 30(3), 32-36.

Rothe, K., Tsokos, M., & Handrick, W. (2015). Animal and human bite wounds. Deutsches Arzteblatt International, 112(25), 433-443.

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