What should be assessed in the physical exam of animal bites?

Updated: Sep 18, 2018
  • Author: Alisha Perkins Garth, MD; Chief Editor: Joe Alcock, MD, MS  more...
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Answer

Major resuscitation rarely is required. With children, reassurance and parental presence may facilitate examination. Where applicable, consider the following:

  • Distal neurovascular status

  • Tendon or tendon sheath involvement

  • Bone injury, particularly of the skull in infants and young children

  • Joint space violation

  • Visceral injury

  • Foreign bodies (eg, teeth) in the wound

Significant damage due to bites is shown in the images below.

Animal bites. The devastating damage sustained by Animal bites. The devastating damage sustained by a preadolescent male during a dog attack. Almost lost in this photograph is the soft tissue damage to this victim's thigh. This patient required 2 units of O- blood and several liters of isotonic crystalloid. Repair of these wounds required a pediatric surgeon, an experienced orthopedic surgeon, and a plastic surgeon. Attacks such as these have caused a movement in some areas of the country to ban certain dog breeds.
Animal bites. Massive soft tissue damage of the ri Animal bites. Massive soft tissue damage of the right leg caused by a dog attack. This patient was transferred to a level one pediatric trauma center for care. At times, staff members may need counseling after caring for mauled patients.

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