Bites Flashcards Preview

Musculoskeletal > Bites > Flashcards

Flashcards in Bites Deck (12)
Loading flashcards...

Name the 2 types of human bite injuries

  • Occlusal injuries: inflicted by actual biting
  • Clenched-fist injuries: clenched fist hits teetch
    • particularly prone to infection


Describe the injuries that occur with dog bites

  • Puncture wounds from canine teeth
  • Stretch lacerations from other teeth


Describe the injuries that occur with cat bites

Wounds penetrate bone and joint capsules


Name 3 complications of bite injuries

  1. Wound infection*
  2. Septicaemia
  3. Septic arthritis
  4. Tenosynovitis
  5. Tetanus
  6. Psychological: anxiety, nightmares, PTSD
  7. Disfigurement


Name 5 factors that increase the risk of infection from bite injuries

  • Hand wounds
  • Diabetes
  • Asplenic
  • Cirrhosis
  • Immunosuppressed


Outline the management of bite injuries

  • Removal of any foreign bodies
  • Encourage bleeding of the wound
  • Thorough irrigation with warm, running water
  • Analgesia if required
  • Human: prophylactic ABX if <72hr
  • Animal: prophylactic ABC if <48 and high risk of infection
  • Seek immediate advice if at risk of HIV or Hep B
  • Refer to A&E for further assessment and management if wound closure necessary
  • Consider need for tetanus and rabies prophylaxis


When should tetanus prophylaxis be given?

  • Primary immunisation incomplete, or boosters not up-to-date
  • Not immunised
  • Immunisation status uncertain


How is an infected bite treated?

  • Send pus or wound swab for culture
  • Empirical oral antibiotics for 7 days
  • Admit anyone with severe infection, or systemically unwell for IV antibiotics

Empirical ABX: co-amoxiclav or metronidazole + doxycycline


When should bite injuries be considered for x-ray?

  • Clenched fist injuries: tooth and bone fragments
  • Crush injury: possibility of fracture or foreign body
  • Penetrating scalp injuries


Name 3 organisms seen in bite injuries

  • Pasteurella multocida: almost all animal mouths
  • Staphylococcus spp.
  • Streptococcus spp.
  • Staphylococcus aureus: humans


What is tetanus?

Infection with Clostridium tetani resulting in the characteristic severe muscle spasms and rigidity.

Risk: wounds contaminated with soil, or caused by rusty metal

Notifiable disease


How many injections are in a tetanus vaccination?

Full course requires 5 injections