MyCpdZw - Protocols Details

HUMAN & ANIMAL BITES

Human and animal bites are relatively common and can result in minor injuries such as puncture wounds, scrapes, cuts or bruising.

Diagnosis

Usually obvious from history.

Often become infected.

Assess risk of infection:

Low risk:

· Uncomplicated, simple wounds seen within 8 hours of injury,

Hisk risk:

· Delayed presentation (over 8 hours),

· Puncture wounds,

· Wounds on hands, feet or face,

· Involvement of underlying structures (bones, joints, tendons),

· Immunocompromised patients.

Management

1. All wounds:

· Thoroughly cleansed with N.Saline,

· Debrided,

· Irrigated,

· Immobilized with splinting &

· Elevated.

2. Excisional debridement recommended for all bites over 6 hours

3. For High risk group presumptive therapy with:

· Augmentin for 5/7.

4. For established infection or severe or penetrating injuries, especially into joints or tendons:

· Metronidazole 400 mg BD for 5-10/7 PLUS

· Ceftriaxone 1 g IV Daily for 5-10/7.

Regular & early follow-up is important

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