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General Bite Wound Management
  • Irrigate thoroughly
  • Update tetanus
  • LOW RISK bites get sutured
    • High risk bites to cosmetic areas (face) get sutured AND antibiotics
    • High risk bites to non-cosmetic areas are left open AND get antibiotics
Rabies
  • Give vaccine if…
    • ANY suspicion for bat bite (bat in room, cave, etc)
    • Bite by wild animal that can’t be monitored
    • Bite by domestic animal that develops symptoms during observation
Black widow spider
  • Painful bite
  • Symptoms
    • Abdominal pain
    • Diaphoresis
    • Myalgias
    • Muscle spasms/cramping
  • Supportive care
Pit Viper Bite
  • Causes Coagulopathy/DIC
  • Swelling around bite site
  • Treat with CroFab antivenin
Brown Recluse Bite
  • Painless bite
  • Ulceration/necrosis around bite site
Altitude Illnesses
  • Acute Mountain Sickness (AMS)
    • Headache
    • Nausea and vomiting
    • Treat with acetazolamide or decent
  • High Altitude Pulmonary Edema (HAPE)
    • Shortness of breath
    • Treat with supplemental oxygen and immediate decent
    • Consider nifedipine or sildefenil
  • High Altitude Cerebral Edema
    • Ataxia
    • Confusion
    • Cushings reflex
      • Bradycardia
      • Hypertension
      • Cheyne-Stokes respirations
    • Treat with supplemental oxygen and immediate decent
    • Consider dexamethasone
Digit Amputation
  • Wrap in saline soaked gauze
  • Put in plastic bag
  • Place on ice
  • Send to surgeon
Tooth avulsion
  • Reimplant tooth in socket
  • Place in glass of milk
Frostbite
  • Remove wet clothing
  • Rewarm at body temperature
Additional Reading