Page 10 - Emergency medicine for students ebook

Symptoms:
Animal Bites
Ø Initial bite: puncture marks shape of teeth, blood
Ø Infected bite: pus or fluid oozing from the wound, tenderness in areas
near the bite, loss of sensation around the bite, limited use of the finger or hand if the hand was bitten, red streaks near the bite, swollen lymph nodes, fever or chills, night sweats
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Pre-hospital Treatment:
1. Wash wound thoroughly with soap and water, pat dry and cover with sterile dressing
2. Go to hospital if: severe bleeding, wound is still dirty, risk of rabies, unsure if received tetanus vaccination
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Hospital Treatment:
1. Clean with normal saline or tap water
2. Refer to specialist if facial or involving tendons or joints
3. Delayed primary closure (3-5days): everywhere except face and hands
(due to infection), if very deep or more than 6hr old
4. Primary closure on face or larger lacerations
5. Co-amoxiclav (or doxycycline + metronidazole if allergic) given if:
o Dog bite less than 3 day old, all cat bites, dog bites involving hand, foot, face, joint, genitals, deep wound affecting tendons/nerves etc, primary wound closure and diabetic/IC/elderly.
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Jelly fish sting:
1. Rinse in sea water to remove stinging cells
2. Immerse in hot water for 30-90 minutes to reduce
pain and swelling
Jelly fish sting http://boxjellyfish.org/box-jellyfish-sting- facts-deadliest-sting/
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