Pediatrics- Bite Injuries, Animal Bites

Your child’s hand is composed of many bones that provide structure for his or her wrist and fingers.  The bones are connected with strong ligament tissues.  Tendons are strong fibers that attach muscles to bones and allow movement.  Your child’s hand also contains nerves, blood vessels, and fat.  The skin that covers your child’s hand protects it from the environment.

The hand is the most common place for animal bites.  Animal bites can result in skin lacerations, puncture wounds, crushed bones, torn ligaments, tendons, and muscles.  They can injure or damage blood vessels and nerves.  Compounding the physical injuries, several types of infections, including rabies, can transmit from the animal’s mouth into the hand. 
 
Dogs have rounded teeth and strong jaws that can cause crushing injuries.  Animal bites can break the skin and cause a puncture wound.  Cats have sharp pointed teeth and cause more puncture wounds than dogs. 
 
Infection is a major concern for all bite injuries.  Most infections from animal bites are mixed infections, meaning that a combination of sources including bacteria, virus, fungal, and other germs cause them.  Rabies is a concern, because without timely treatment, rabies is fatal.  Most pets in the United States are vaccinated against rabies.  The majority of rabies cases occur from wild animals such as skunks, bats, or raccoons.
 
Pets are a common cause of animal bites.  Dog bites occur most frequently, followed by cat bites.  Stray animals and wild animals also cause bite injuries.  Skunks, raccoons, foxes, bats, rodents, reptiles, and farm animals may bite people if they are sick, provoked, or feel threatened.
 
If an animal bites your child, you should try to keep the animal in view and contact your local animal control experts to capture it.  They may quarantine the animal and check it for rabies.  They can also verify the rabies vaccination status of stray pets.

An animal bite can cause pain and swelling.  It may be difficult for your child to move his or her fingers or wrist if the bones, muscles, tendons, ligaments, or nerves are injured.  Your child may experience a loss of sensation or tingling in his or her fingers.

You should inspect your child’s hand for puncture wounds and bleeding.  Signs of infection include warmth, redness, pain, and tenderness.  Drainage of pus can occur with abscess formation.  Infections can also cause a fever, chills and or sweats.

You should contact your doctor if your child suffers an animal bite.  You should carefully wash the wound with soap and water, unless the area is actively bleeding.  If your child experiences bleeding, apply direct pressure with a clean dry cloth and elevate your child’s hand above the level of his or her heart.  You should take your child to your doctor or an emergency department for immediate treatment of bleeding.

You should tell your doctor what kind of animal bit your child and how your child received the bite.  Your doctor will examine your child’s hand and arm.  An X-ray may be ordered if structural damage is suspected.

Your doctor will carefully wash and remove any foreign material from your child’s wound.  Your doctor may order a blood test to check for infections.  A tetanus shot and antibiotics may be needed to help prevent infection. 

If rabies is identified or suspected, your child will receive a series of vaccinations.  The medication is highly effective if received in the first stage of rabies.  As the consequences of rabies are so severe, you should always promptly contact your doctor if your child suffers an animal bite.

Animal bites that puncture the skin require careful cleaning.  Wounds are usually kept open, instead of stitched shut, to help avoid infection.  If your child has an infection, he or she may receive antibiotic medication, antibiotic ointment, or IV antibiotics.  Your child’s wound will be loosely bandaged.  Your doctor will provide your child with home care instructions.  It is very important to attend your child’s follow-up appointments so that your child’s condition can be monitored.

Surgery may be necessary if bones, blood vessels, muscles, tendons, ligaments, or nerves are injured, or if an abscess develops.  The type of surgery that your child receives depends on the type and extent of his or her injury.  Your child will most likely participate in hand therapy rehabilitation following surgery.  The goal of surgery is to return your child’s hand structure and function to its pre-injured condition.

 

Recovery from animal bites is an individualized process.  Your child’s recovery will depend on the extent of his or her injury or infection and the type of treatment your child receives.  Your doctor will let you know what to expect.  Attend all of your child’s doctor and hand therapy appointments to ensure the best recovery possible. 

Teach your children about animal bite prevention.  There are several ways that your child may be able to prevent animal bites.  Teach your child not to approach, pick up, or play with any type of wild animal.  Your child should not try to separate animals that are fighting.  Your child should avoid animals that appear sick or that are acting odd—call your local animal control service to have the animal picked up.  Your child should not provoke or tease animals.  Your child should not approach pets when they are eating.  Keep your pet on a leash in public and make sure your pet’s vaccinations are up-to-date.  Your child should not touch other's pets without asking permission of the owner first.