Week 5 Discussion
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Week 5 Discussion Case Questions
1.
What are the possible complications of dog bite wounds?
Infection
Bleeding
Pain
Skin tearing potential muscle or bone injury
Disfigurement
Nerve damage
Emotional trauma
Fever
MRSA
Sepsis
Tetanus (Desai, 2020)
2.
What should the practitioner ask the family about the dog?
Who owns the dog?
Did you know the dog?
Where were you when this happened?
Where is the dog now?
Did the dog look well kept?
Was the dog growling and drooling?
Was the dog big or small?
Do you know what type of dog it was?
What were you doing when you were bit?
3.
What are the indications for antibiotic prophylaxis in dog bite wounds?
Signs of infection (fever, redness, swelling)
If the dog is known to/or looks as though it has rabies
Wound is deep and exposing muscle
Multiple wounds are present
The person who was bitten is immunocompromised (Baddour & Harper, 2022)
4.
What are the indications for tetanus prophylaxis in dog bite wounds?
If the most recent vaccine was greater than 5 years ago
If a child has received less than three doses
If the patient is unsure of their last tetanus vaccine (Baddour & Harper, 2022)
5.
How would you clean and dress the wounds?
If the would is a small cut, you could clean the wound with soup and water
or betadine and then Neosporin could be added with a clean bandage. If the wound is large and deep, then you can irrigate it with normal saline to help wash away any dirt and saliva from the dog. Hold pressure until the wound is not bleeding anymore and then apply a sterile bandage. Antibiotics will be prescribed to prevent infection. Stitches or surgery may be needed depending on the wounds size and depth. Pain medication such as Tylenol may be used for the patient (Brouhard, 2024).
6.
How would you manage the pain and anxiety of the girl?
To manage the pain of the three-year-old, I would give her some acetaminophen and lidocaine if needed. A cold compress may also be used. For her anxiety, I would make sure one or both parents were able to stay with her and offer her a lollypop or coloring pages to help distract her from her discomfort and anxiety.
7.
How would you counsel the parents about preventing future dog bites?
Teach their daughter:
Do not touch or approach dogs she does not know
Be calm and gentle when around new animals
Do not chase a dog
Teach the daughter how to pet and be gentle with dogs
Parents:
Be aware of your surroundings when around a new dog
Do not leave your child alone with an animal 8.
Would these wounds be classified as low-risk or high-risk for infection? Explain.
I would classify these wounds as high-risk for infection because they are open wounds and due to the patient’s age. The ear has a 2cm laceration with dirt and dry blood and the hand wounds are about 1cm deep and open which need to be treated for infection even if no signs are being shown yet. The parents need to monitor their daughter for fever and redness or swelling of the areas to help prevent future infection. 9.
What legal obligations, if any, do you have regarding this patient?
Legally, healthcare facilities have to report dog bites, especially if it’s the family dog. This does not mean your child is at risk of being taken away or your dog. Animal control may stop by to see the dog and to make sure it does not oppose a threat. Depending on the case, or if it happens again CPS may come by to make sure the child is in a safe environment (Cannon, 2024). References
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