Clinical Reference Systems: Pediatric Advisor 10.0
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Description

1. Bites from rabies-prone wild animals

   Rabies is a fatal disease. Bites or scratches from a bat, skunk, raccoon, fox, coyote, or large wild animal are especially dangerous. These animals can transmit rabies even if they have no symptoms. Bats have transmitted rabies without leaving a detectable bite mark on the skin.

2. Other wild animal bites

   Rodents such as mice, rats, gophers, moles, chipmunks, prairie dogs, and rabbits fortunately are considered free of rabies. Squirrels rarely carry rabies. Rodents can carry other diseases (such as plague).

3. Outdoor pet bites

   Most bites from pets are from dogs or cats. Bites from domestic animals such as horses can be handled using these guidelines. Dogs and cats are free of rabies in most metropolitan areas. The main risk in pet bites is serious wound infection, not rabies. Cat bites become infected more often than dog bites. Claw wounds are treated the same as bite wounds, since they are contaminated with saliva.

4. Indoor pet bites

   Small indoor pets (gerbils, hamsters, guinea pigs, white mice, etc.) are at no risk for rabies. Puncture wounds from these small animals usually do not need to be seen by a doctor. This kind of wound rarely goes through the skin.

5. Human bites

   Most human bites occur during fights. Sometimes a fist is cut when it strikes a tooth. Human bites are more likely to become infected than animal bites. Bites on the hands are at increased risk of complications. Most toddler bites don't break the skin and don't need to be seen.

   For help with children who deliberately bite, see Biting.

First Aid for Suspected Rabies Contact

Wash the wound immediately with lots of soap and water for 10 to 15 minutes. If possible, flush the wound thoroughly under a faucet. If a wild animal or sick pet animal is still on the premises, call the police department immediately. If the animal is captured or dead, avoid all contact with it. Saliva from a rabid animal can cause rabies if it gets into a cut.

Home Care for Animal Bites (When Rabies Not Suspected) and for Human Bites

1. FIRST AID for puncture wound or laceration (deep cut)

   Wash the wounded area with water and liquid soap for 10 minutes before going to your physician's office. Scrub the wound enough to make it rebleed a little. Also check to see when your child last had a tetanus shot. (If your child has not had a tetanus booster in 5 years, he needs one within 3 days.)

2. Scrapes and superficial cuts

   For wounds that don't penetrate deeply into the skin, wash the area of the injury with water and liquid soap for 10 minutes. Apply an antibiotic ointment to the wound twice a day. You can leave it exposed to the air, or put a Band-Aid on it if it's an area that gets dirty easily.

3. Pain relief

   Give acetaminophen or ibuprofen for pain.

4. Observation of the pet

   If there is any possibility of rabies, the pet should be observed carefully for any signs of sickness. The pet should be isolated from contact with humans for 10 days. If the animal belongs to another family and they are not cooperative, report the incident to your city's or county's animal control division.

5. Prevention of animal bites

   Teach your children not to pick up sick or injured wild animals. Teach them not to pet strange dogs, try to break up dogfights, go near a dog that's eating, or touch a sleeping dog. Children under 4 years of age should always be supervised around dogs. Pit bull terriers, German shepherds, Dobermans, and St. Bernards are especially dangerous.

Call Your Child's Physician Immediately If:

• The animal could have rabies.
• The teeth or claws went through the skin (that is, all puncture wounds). Note: Cat bites of the hand can become infected rapidly and need prompt attention.
• The skin is split open (that is, may need stitches).
• The bite looks infected (red streaks or increasing redness).
• Your child starts to act very sick.

Call Your Child's Physician During Office Hours If:

• The pain increases after the second day.
• The bite wound isn't healed in 10 days.
• You have other questions or concerns.