Today is our topic of discussion Management of animal bite
Management of animal bite
Post-exposure prevention:
Depends on category of exposure (table below). Basic treatment plans are-
Wound wash:
Wash the wound with running tap water or speedy running water and soap for 15 minutes. The wound let remained open, but just approximation (if necessary).
Assess the wound:
According to WHO guideline (exposure category)
Vaccination:
Anti-rabies vaccination (ARV) with IDRV/TCV
Rabies Immunoglobulin (RIG):
In category III exposure (not later than 7 days after 1″ vaccination
Tetanus toxoid:
When indicated
Antibiotic (systemic):
Where necessary
Symptomatic rabies:
- Referral to appropriate health facility to be done (District Isolation Hospitals & IDH, Mohakhali).
- There is no specific treatment of rabies; supportive and symptomatic treatment is the aim.
- Isolation in a quiet room protected as far as possible from bright light, noise and cold draughts of air.
Dose of RIG:
40 IU/Kg BW for equine (FAVIRAB) & 20 IU/Kg BW for human RIG. Do skin sensitivity test before RIG and infiltrate locally. The rest (if any) to the deep IM at a site distant from the site of accination. Multiple needle injections into the wound should be avoided.
Positive test reaction:
Induration >10mm with or without constitutional symptoms. If skin test is positive – Human RIG is preferred. If equine RIG has to be administered then pre-treat with Adrenaline and Antihistamine before administering full dose; negative test is not a guarantee that anaphylaxis will not occur
reFig: Positive test reaction for RIG
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