Animal Bites in Emergency Medicine Clinical Presentation

Updated: May 16, 2017
  • Author: Alisha Perkins Garth, MD; Chief Editor: Joe Alcock, MD, MS  more...
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Presentation

History

The history in patients with animal bites should include the following:

  • Time and location of event
  • Type of animal and its status (ie, health, rabies vaccination history, behavior, whereabouts)
  • Circumstances surrounding the bite (ie, provoked or defensive bite versus unprovoked bite)
  • Location of bites (most commonly on the upper extremities and face)
  • Prehospital treatment
  • Patient’s medical history (immunocompromise, peripheral vascular disease, diabetes, tetanus and rabies vaccination history)
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Physical Examination

Major resuscitation rarely is required. With children, reassurance and parental presence may facilitate examination. Where applicable, consider the following:

  • Distal neurovascular status
  • Tendon or tendon sheath involvement
  • Bone injury, particularly of the skull in infants and young children
  • Joint space violation
  • Visceral injury
  • Foreign bodies (eg, teeth) in the wound

Significant damage due to bites is shown in the images below.

Animal bites. The devastating damage sustained by Animal bites. The devastating damage sustained by a preadolescent male during a dog attack. Almost lost in this photograph is the soft tissue damage to this victim's thigh. This patient required 2 units of O- blood and several liters of isotonic crystalloid. Repair of these wounds required a pediatric surgeon, an experienced orthopedic surgeon, and a plastic surgeon. Attacks such as these have caused a movement in some areas of the country to ban certain dog breeds.
Animal bites. Massive soft tissue damage of the ri Animal bites. Massive soft tissue damage of the right leg caused by a dog attack. This patient was transferred to a level one pediatric trauma center for care. At times, staff members may need counseling after caring for mauled patients.
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Causes

Bite wounds from cats and dogs can occur without provocation, but provoked bites, such as disturbing animals while they are eating, are more common. Older animals often are less tolerant of disturbances, especially by children. Most dog bites involve a dog that belongs to the family or friend of the victim and approximately half occur on the pet owner's property. [14]

Unprovoked bites by wild or sick-appearing animals (most notably by dogs, cats, raccoons, foxes, skunks, and bats) further raise underlying concerns about likelihood of rabies exposure.

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Complications

Complications of bite wounds may include the following:

  • Wound infection
  • Sepsis
  • Cosmetic deformity
  • Loss of limb
  • Loss of function
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