BITES AND STINGS

Wounds caused by teeth, fangs or stings.

Causes

  • Animals (e.g. dogs, snakes), humans or insects

Clinical features

  • Depend on the cause

General management

First aid
  • Immediately clean the wound thoroughly with plenty of clean water and soap to remove any dirt or foreign bodies
  • Stop excessive bleeding by applying pressure where necessary
  • Rinse the wound and allow to dry
  • Apply an antiseptic: Chlorhexidine solution 0.05% or Povidone iodine solution 10%
Supportive therapy
  • Treat anaphylactic shock
  • Treat swelling if significant as necessary, using ice packs or cold compresses
  • Give analgesics prn
  • Reassure and immobilise the patient
Antibiotics
  • Give only for infected or high-risk wounds including:
    • Moderate to severe wounds with extensive tissue damage
    • Very contaminated wounds
    • Deep puncture wounds (especially by cats)
    • Wounds on hands, feet, genitalia or face
    • Wounds with underlying structures involved
    • Wounds in immunocompromised patients
  • See next sections on wound management, human and animal bites for more details
Tetanus prophylaxis
  • Give TT immunisation (tetanus toxoid, TT 0.5
    ml) if not previously immunised within the last 10 years

Caution

  • Do not suture bite wounds