How to know if dog bite is healing
Doctor explains how to assess and treat dog bites
Timecodes:
[Music]
hello welcome back to dr donovan
medicine made easy in today's video
we're going to be covering management of
dog bites in this video we're going to
give a brief background of what dog
bites involve how to assess the patient
we'll then cover the risks that dog
bites present and finally we'll go over
management and treatment options so
first of all what kinds of dog bites are
there well bite wounds can take a number
of forms including lacerations puncture
wounds or crush or degloving injuries
dog bites characteristically involve
punctual wounds from the canine teeth
which anchor the victim whilst the other
teeth bite shear and tear the tissues
causing structural damage and they're
the most common type of mammal bite
so let's move on now and briefly discuss
assessment of dog bite wounds so when
assessing the patient it's important to
record the circumstances under which the
bite occurred including when it happened
whether the dog was domesticated or wild
and how the dog appeared so by this i
mean was it a healthy looking dog and
you also want to know whether the attack
was provoked or not you should then take
a full set of observations from the
patient including their temperature and
ensure that you examine the bite using
gloves bearing in mind that deep layers
of tissue may move with positional
changes after the bite injury therefore
disguising the true depth of the wound
when you document make sure you describe
the size depth and location of the wound
and if possible with the consent of the
patient try to take a photographic image
of the wound and store it in the
patient's electronic records if
available
it will be important to also record if
there is any non-visible tissue damage
any nerve or tendon damage as well as
involvement of muscles bones joints or
blood vessels is that important to
assess neurovascular function in the
area distal to the bite you want to
check the pulses and sensation and then
you want to assess the range and
movement of any adjacent joints and look
for any foreign bodies that might be
present in the wound finally you want to
assess for any signs of infection so for
example things like redness swelling
injuriation or necrotic tissue and
purulent discharge as well as any
spreading cellulitis if the patient has
a facial bite then make sure you perform
an inter-oral examination to exclude
cheat lacerations communicating with
your cavity
so we're going to move on now and
discuss the risks of dog bites and one
of the most important risks from a dog
bite is bacterial infection especially
if there's a break in the skin some of
the infective complications resulting
from bite wounds include things like
abscesses tenocynovitis septic arthritis
osteomyelitis which is infection of the
bone and more distant spread of the
infection to other organs of the body
which could cause sepsis another risk is
that of tetanus especially if the wound
is a puncture wound and it gets dirt in
it rabies in the uk is very rare because
there's no indigenous rabies however if
you're in a country where rabies is
endemic then you'll need to seek urgent
medical attention for post exposure
prophylaxis and i've included a link in
the description box of this video from
the who for more information on the risk
of rabies based on individual countries
so finally let's wrap up this video by
talking about management and treatment
of a dog bite so first of all you want
to make sure you remove any foreign
bodies so for example teeth or dirt from
the wound you want to encourage a wound
that has just occurred to bleed unless
it's already bleeding freely once you've
done this you want to make sure that you
irrigate the wound fully with warm water
that is running and you want to do this
for several minutes you then need to
consider the need for debridement which
is essentially where the skin is cleaned
and any dead skin is removed this is
typically done by the plastic surgery
team or it can be done in the emergency
department you then want to advise
appropriate analgesia so things like
ibuprofen or paracetamol for pain relief
if needed or something stronger like
morphine if required you need to ensure
that you refer to the emergency
department for further assessment and
management if wound closure is thought
to be necessary and in terms of
antibiotics well for an animal bite you
can prescribe prophylactic antibiotics
if it penetrated vital tissues cause
significant damage or the wound is
contaminated or involves high risk areas
of skin or if the person is at risk of
wound infections in terms of antibiotics
well for animal bites such as a dog
empirical antibiotic treatment usually
involves coamoxoclav for seven days in
an adult or if the patient is penicillin
allergic something like doxycycline
combined with metronidazole it'd also be
important to consider the need for
tetanus prophylaxis as well as rabies
depending on the area that you're in
this brings us to the end of the video
which i hope was helpful and informative
as ever if you did enjoy the video
please remember to like it and also
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education videos any questions comments
queries please leave them in the comment
section below and also check out the
description box of this video where i've
posted a whole host of useful links
including links to patient information
leaflets informational rabies as well as
direct links the nhs website thanks
again for watching until next time bye
[Music]
you
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