Description
These are injuries which are inflicted by animal or human teeth. Common animal bites are due to dogs, snakes, crocodiles, and hippo attacks
Signs and Symptoms
- Open wounds
- Bleeding
- Swelling which can lead to compartment syndrome
- Associated fractures or amputations if inflicted by large animals
Treatment
Supportive
- Generously irrigate the wound with normal saline
- Adequate debridement of the wound
- DO NOT SUTURE WOUNDS. Leave the wound open for delayed primary or secondary suture except for facial bites and actively bleeding vessels
- Limb elevation to reduce swelling
- If there is compartment syndrome, fasciotomy must be done
- Partial-traumatic amputation requires surgical completion, aggressive debridement and wound care.
Pharmacological
- Tetanus toxoid, 0.5ml intramuscularly as a single dose.
- If the bite is from a suspected rabid animal, administer post-exposure rabies treatment.
- For snake bites, refer to section on medical emergencies in main Zambia STG
Major Bites
- Ceftriaxone Adult: 2g IV once daily. Children 50mg/kg once daily, maximum 2g daily.
- Metronidazole Adult: 500mg IV 3 times daily. Children 7.5mg/kg 3 times daily.
- Tramadol Adult: 50mg IV/PO 1-3 times daily
WITH
- Paracetamol Adult 500mg-1g IV/PO 3 times daily. Children 10-15mg/kg 3 times daily.
Minor Bites
- Amoxicillin/Clavulanic Acid Adult: 625mg PO 2-3 times daily. Children 15-30mg/kg (based on Amoxicillin component) 2-3 times daily.
- Metronidazole, adults; 200-400mg orally 3 times daily, children; 7.5mg/kg orally 3 times daily for 5 days
- Paracetamol Adult 500mg-1g IV/PO 3 times daily. Children 10-15mg/kg 3 times daily
AND/OR
- Ibuprofen Adult: 400mg 3 times daily. Children: 10mg/kg 3 times daily
Complications
• Infection with both aerobic and anaerobic bacteria and viruses.
• Compartment syndrome
• Gangrene
• Loss of limb/disability