* Bite or claw wound from a pet, farm, or wild animal
* Bite from a human child or adult
Risk of Bites Animal or human bites usually need to be seen because all of them are contaminated with saliva and prone to wound infection.
Types of Wounds:
* Bruising: There is no break in the skin. There is no risk of infection.
* Scrape (Abrasion) or Scratch: A superficial wound that doesn’t go all the way through the skin. There is low risk of infection. Preventive antibiotics are not indicated.
* Laceration (Cut): A wound that goes through the skin (dermis) to the fat or muscle tissue. There is an intermediate risk of infection. Most need to be seen. Wound cleansing and irrigation can help prevent infection by washing out the bacteria from the wound. Preventive antibiotics may be required.
* Puncture Wound: There is an intermediate risk of infection. Puncture wounds from cat bites are especially prone to getting infected; many physicians will prescribe preventive antibiotics for cat bites.
Types of Bites:
* 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. In the United States, 90% of cases of rabies in humans are attributed to bats. Bats have transmitted rabies without a detectable bite mark.
* Small Wild Animal Bites: Rodents such as mice, rats, moles, gophers, chipmunks, prairie dogs, and rabbits fortunately are considered free of rabies. Squirrels rarely carry rabies but have not transmitted it to humans.
* Large Pet Animal 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 metro areas. Stray animals are always at risk for rabies until proven otherwise. Cats and dogs that are never allowed to roam freely outdoors are considered free of rabies. The main risk in pet bites is serious wound infection, not rabies. Cat bites become infected more often than dog bites. Claw wounds from cats are treated the same as bite wounds because the claws may be contaminated with saliva.
* Small Indoor Pet Animal Bites: Small indoor pets (eg, gerbils, hamsters, guinea pigs, white mice) are at no risk for rabies. Tiny puncture wounds from these small animals also don’t need to be seen. They carry a small risk for wound infections.
* Human Bites: Most human bites occur during fights, especially in teenagers. 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. Many toddler bites are safe because they don’t break the skin.
Dogs and Cats and the Risk of Rabies
* Indoor Versus Outdoor Pets: Dogs and cats that are never allowed to roam freely outdoors are considered free of rabies. Outdoor pets who are stray, sick, or unvaccinated AND living in communities where rabies occurs in pets are considered at risk for rabies in the United States and Canada.
* Metropolitan Versus Rural Location: Dogs and cats in most metropolitan areas in the United States and Canada are free of rabies (EXCEPTION: towns along the border with Mexico). Dogs and cats in rural areas have a higher risk of rabies.
* Provoked Versus Unprovoked Bite: An unprovoked attack by a domestic animal increases the likelihood that an animal is rabid. Note that bites inflicted while a person is attempting to feed or handle a healthy animal are considered provoked.
* Developing Countries Versus United States and Canada: Dogs and cats in developing countries have a higher risk of rabies; rabies postexposure prophylaxis is indicated if a bite occurs in a developing country. International travelers need to remain alert. Nurses and physicians must check with the local public health department about the risk for rabies in their community.
First Aid Advice for Bleeding: Apply direct pressure to the entire wound with a clean cloth.
First Aid Advice for All Bites and Scratches: Wash all bite wounds and scratches immediately with soap and warm water.
Based on recommendations/advice in “My Child is Sick; Expert Advice for Managing Common Illnesses and Injuries”, 14th Edition, by Barton D. Schmitt