Animal attacks


Animal attacks

Most animal attacks are from “man’s best friend,” the pet dog. Other animals that will attack humans, given provocation, include the cat, rat, raccoon, tiger, lion, skunk, squirrel, camel, cougar (mountain lion), elephant, bear, alligator, crocodile, bat, wolf, rhinoceros, and hippopotamus. Although there are unique variations to the nature of the wounds created by different animals (in most part related to the size of the animal, types of teeth and claws, and risk of infection), the basic out-of-hospital management of an animal bite or mauling is the same for all creatures.When around wild animals in either a wilderness or domestic setting, use good hygiene and avoid handling the animals, their feces, or the dirt in which they have their nests or latrines. For instance, these precautions apply to avoid becoming devastatingly ill from infestation with the Baylisascaris procyonis roundworm, which is carried by raccoons, or afflicted by Ascaris lumbricoides (roundworm), which causes ascariasis.

General treatment

  • 1.

    If a person is bitten or mauled by an animal, apply direct pressure to stop any brisk bleeding, and follow the instructions for management of bleeding and cuts (see pages 60 and 279).

  • 2

    It is important to clean the wounds well. Flush any injury that has broken the skin with at least 2 quarts (liters) of disinfected water, scrub with mild soap, and flush again. If you’re carrying povidone–iodine (Betadine) solution 10% (not soap or scrub); benzalkonium (Zephiran) liquid 1% antiseptic; or, in a pinch, Bactine antiseptic (benzalkonium 0.13%), rinse the wound with one of these for 1 minute (to help kill rabies virus), and then rinse away the solution until there is no discoloration of the wound.

  • 3.

    Don’t tightly sew or tape closed any animal bite unless it’s absolutely essential to allow rescue. If a large tear is present, the wound edges can be held together with tape and wraps (see page 285). Tight closure of a contaminated wound (all animal bites and scratches introduce bacteria into the wound) can lead to a devastating infection. Apply a thin layer of bacitracin or mupirocin ointment or mupirocin cream into the wound.

  • 4.

    If the victim is more than 5 hours from a physician, administer amoxicillin–clavulanic acid. If a person no longer has a spleen, either because it is not present or not functioning properly (e.g., persons with sickle cell anemia), then be certain to administer an antibiotic as soon as possible after the bite occurs. Alternative antibiotics include cefuroxime axetil, dicloxacillin, azithromycin, cefixime, cephalexin, trimethoprim–sulfamethoxazole, or norfloxacin with clindamycin. If the victim is allergic to penicillin, and if the bite is from a dog, administer clindamycin with levofloxacin, or for children clindamycin with trimethoprim–sulfamethoxazole; if the bite is from a cat, use cefuroxime axetil or doxycycline; if the bite is from a raccoon or skunk, use doxycycline. If the bite is from a cat, domestic or wild, administer an antibiotic as soon as possible. (see fluoroquinolone antibacterial drugs precaution on page 498). Animal bite wounds of the hands and feet seem particularly prone to bacterial infection. If an animal bite becomes infected, the same antibiotics are recommended, with the exception that for cat (domestic and “big” cat) bites, dicloxacillin should be given with penicillin.

Special considerations

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