Aug 19, 2020

TRANSCRIPT

Interviewer: What is the thing you should be worried about if you end up with a dog bite? We're going to talk about dog bites next on The Scope.

Dr. Troy Madsen's an emergency room physician at University of Utah health care. And if you get bitten by a dog, what do you need to know? Dr. Madsen, go.

Infection from Animal Bites

Dr. Madsen: So the biggest thing we think about with dog bites are infection. That's probably the first thing that comes to mind for me in any kind of bite dog, cat, whatever, but in particular with dog bites. So when I see someone with a dog bite, first of all, I'm looking at the wound itself. Are they moving their hand okay? Let's say they got bitten on their hand or on their forearm. Do all the tendons seem like they're intact? Can they feel? Are the nerves working okay? Is the blood flowing okay, making sure there's no damage to any of the vessels there? So anything I would do it any sort of laceration, that's what I'm doing with the dog bite.

But the big thing, I think, about say someone falls and cuts their arm or cuts their arm with a knife or something like that versus a dog bite would be the infection risk because dogs, like any other animal including humans, have lots of germs in their mouth. So typically what I'm thinking about there is getting the wound cleaned out really well, making sure it's washed out really well. And then often with these bites I'll put people on antibiotics. So I think if you're bitten by a dog that's the big thing you're thinking about is, number, one getting this cleaned out really well. Number two, was it a fairly deep wound or something where maybe you should be on antibiotics for a few days to prevent an infection there.

Interviewer: All right, so if you take a look at it and it's a deep wound then it's a no brainer, you probably should go to the ER?

Dr. Madsen: You really should.

Interviewer: The instant care would they be able to handle something like?

Dr. Madsen: Instant care would be fine.

Interviewer: They'll be able handle that as well and get that stitched up. But if it's just kind of a minor bite, they kind of broke the skin a little bit, then you need to watch out for infection.

Home Care for Minor Bites

Dr. Madsen: You do. And I think if it's a minor bite in those situations, if it were me, I would just wash it out really well.

Interviewer: Soap and water?

Dr. Madsen: Sure. You can use some soap and so might kind of might hurt. Quite honestly, if you just run the tap, just get a lukewarm water going, put your arm or whatever affected body part of was put it under there, let it just run for five or ten minutes, just wash that out really well, that's really going to do the job. And you can avoid putting a lot of soap on there, causing a lot of pain. I think just getting lots of water running through it, just flushing it out is going to be effective, and you know you can try some antibiotic ointment on there as well. But I think the big thing to watch for there is any signs of infection where it starts to get red, swollen, getting drainage from the wound, then absolutely in that situation, you need to get to an urgent care or an ER, get in and get on some antibiotics.

Interviewer: Some redness is normal though right after a bite like that?

Dr. Madsen: Some redness, yes, but I expect usually the redness is going to go down within 24 hours. If it's getting bigger after 24 hours, that's a sign of infection.

Interviewer: And get that taken care of immediately.

Dr. Madsen: Exactly.

Animal Bites and Potential for Rabies

Interviewer: All right. So if it's a dog that's known to you then I think we've covered it. But if it's a dog that's not known to you, then you've got people worried about rabies.

Dr. Madsen: So the big thing to know is if you know the dog, if it's your dog, if their shots are up to date, you can observe the dog after the bite, you don't need to rush in and get rabies shots. If it's a dog where this is some random dog, and you don't know whose dog it is and you don't know where the dog went, you need to think about rabies, and that's something to go to the ER for or an urgent care could handle this as well to look at getting the rabies vaccine to prevent rabies.

Interviewer: When a dog that's not known to you attacks you, would they be showing symptoms and signs of rabies? Or could they be asymptomatic, not showing those symptoms and signs and still have rabies?

Dr. Madsen: They could. It's hard to say and it may not be florid rabies where it's classically you know you hear foaming at the mouth as rabid dog. But just any time you're bitten by a dog and you just cannot track that dog afterwards or you just don't know if they've had their shots, you need really need to get the rabies vaccine in that situation.

Interviewer: And don't wait for, "I'll just see how I feel."

Dr. Madsen: Yes, don't wait to see if you get rabies and wait for that because there's not much you can do once you have rabies.

Interviewer: Is there anything else to keep in mind when it comes to a dog bite?

Dr. Madsen: I think the big things again are watch for infection, and use your judgment in terms of getting to the ER to get on antibiotics depending if this is a larger wound versus something you could just wash out treat at home. Again, always think about rabies if you don't know the dog, you don't know whose dog it is, get in, get the rabies vaccine.


updated: August 19, 2020
originally published: August 19, 2016

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