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ESSAY: Wounds

A 3-year-old girl arrives at the clinic accompanied by her parents. The family has a dog that bit the girl, and she has bite wounds on her hand and ear. The ear is torn, but it is not actively bleeding. The hand has three puncture wounds in the soft tissue, none of which are actively bleeding. However, bruising is noted on the hand around the area of the puncture wounds. The parents report that the bite occurred within the last 45 minutes.

Case Questions

Would these wounds be classified as low-risk or high-risk for infection? Explain.
What should the practitioner ask the family about the dog?
What objective assessments should the practitioner complete?
How should the wounds be managed?
If the dog’s rabies vaccination is not current, what should the practitioner do?
What patient education should be included?

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Instances of dog bites are common, especially among children. When they happen, a child is always at high risk when the dog has not been vaccinated. It is, however, essential to have immediate medical attention when such instances occur.

Whether The Wounds Are Low Risk or High Risk

The wounds from the 3-year-old are low-risk wounds based on two reasons. One, the wounds are not bleeding, which means they are probably not exposed. Although there are puncture wounds, there is no point of entry for the bacteria. The second reason is that bacteria may accumulate in a wound bite after 24 hours of exposure. The 45 minutes may not be enough to classify the wound as a high-risk (Hardanahalli, Srikanth, Anandaiah & Annadani, 2017).

What The Practitioner Should Ask About The Dog

The first question the practitioner should ask the family is whether the dog had been vaccinated against rabies and when the vaccination took place. If the answer is yes, then the child is at low risk of infection. However, if there was no vaccination, the child may be at risk and needs urgent medical attention.

Objective Assessment

The objective assessments that a practitioner can make include asking questions such as:

  1. How often do you play with the dog?
  2. Has the dog ever been vaccinated?
  3. When was the dog vaccinated last?
  4. How long ago did the incident happen?

How the wound should be managed

The wound should be managed by cleaning with soap and warm water. A clean cloth should be used to clean the wound by slowly pressing against the surface. An antibacterial ointment should further be applied to the wound, and a bandage used to cover. Any signs for infection should be carefully monitored (WHO, 2018).

If The Dog’s Rabies Vaccination Is Not Current, What Should the Practitioner Do?

If the rabies vaccination is not current, that can be likened to lack of vaccination and hence the child can be at a very high risk of getting rabies. The practitioner should give post-exposure rabies prophylaxis (PEP)

What Should Patient Education Be Included? The parents should be educated on the need to be vaccinating the dog every one to three years. All dogs should be vaccinated for rabi…

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