BITES

Dog Bites

When managing bites from dogs or other domestic animals, there are three crucial steps to follow. The first step is local wound care. If the bite results in only a minor abrasion, it should be thoroughly cleaned with soap and water, followed by the application of an antibiotic ointment. It is essential to monitor the wound closely for any signs of infection, such as pain, swelling, redness, red streaks, fever, or discharge from the wound.

Should any of these symptoms arise, it is important to schedule an appointment with one of our physicians during regular office hours. For more extensive wounds that go beyond a minor abrasion, urgent medical care is advised. In some cases, antibiotics are recommended for animal bites that penetrate the skin.

The second step in managing animal bites involves assessing the risk and prevention of rabies infection. When the animal is well-known and vaccinated against rabies, the risk of transmission is minimal. The animal should be confined and observed for ten days; if it remains healthy, there is no need for rabies prevention.

However, if your child is bitten by a stray or wild animal, an animal that cannot be located, a bat, or an animal that subsequently dies, it is crucial to seek medical attention immediately. The Arkansas State Health Department can assist us in determining whether rabies vaccination is necessary.

Regarding bats, if a bat is found in your child’s bedroom even if no bite marks are found, make an appointment with one of our physicians. Rabies vaccination is recommended in this situation. In addition, it is important to strictly avoid sick or deceased wild animals due to the rabies risk. For bites with a high rabies risk, you should make an appointment with us during regular office hours.

Finally, as with any significant wound, ensuring that the tetanus immunization is up-to-date is vital. After an animal bite or other contaminated wound, a tetanus booster is required if the child has not received one within the past five years. If your child’s tetanus vaccination is not current and a wound occurs, visiting our office during regular hours is imperative to receive the necessary immunization.

Human Bites:

Human bites should be treated like domestic animal bites with evaluation by the physician if a significant break in the skin occurs. Of course, the offending biter should not be kept up for ten days. He should just be appropriately disciplined.

Insect Bites and Stings:

Most insect bites and stings are not dangerous unless the child is severely allergic to a particular bite or sting. These bites however can be quite painful. Please know that wasp and hornet stings can create a large circular area of redness around the site of the sting. Only if these become large (bigger than 4 or 5 inches), do we become concerned.



Treatment:

1. If the stinger is present, remove it with a horizontal scraping motion.
2. Place a cold compress on the bite for several minutes to reduce swelling and resulting redness of the bite or sting. You should expect some redness and swelling to occur. You should call the office if this becomes severe (redness and swelling 4 or 5 inches in diameter).
3. Treat with Benadryl elixir (see Dosing Guide) to help relieve the symptoms.
4. Apply 1% Hydrocortisone ointment or cream to the area to help with further itching. This is available without a prescription.
5. Go to the nearest emergency room if your child develops difficulty in breathing and or becomes very pale and begins to feel faint.
6. Use acetaminophen (Tylenol) for pain (see Dosing Guide).

Snake Bites:

Nonpoisonous snake bites are treated the same as bites from a dog or other domestic animal. Reptile bites do not cause rabies. If your child is bitten by a poisonous snake, it is crucial to remain calm and take immediate action.



First, keep your child as still and calm as possible to slow the spread of venom. Position the bite area at or below the level of the heart and remove any tight clothing or jewelry near the bite since swelling is likely to rapidly occur. Do not attempt to suck out the venom or apply ice to the wound, as these actions can do more harm than good. Instead, use a clean, dry bandage to cover the bite site lightly.

Identify the snake if possible but only if it is safe to do so. Noting its size, color, or markings can help healthcare professionals choose the appropriate treatment. You may also take a photo of the snake if possible to aid in identification.

Next, seek medical help immediately. Call 911 or take your child to the nearest hospital as soon as possible. While waiting for medical assistance, continue to keep your child still and provide reassurance. If your child begins to feel faint, has trouble breathing, or experiences chest pains, lie them flat with their legs elevated, assuming it does not exacerbate any breathing difficulties.

Antivenom treatment is most effective within a couple of hours after the bite, so prompt medical attention is vital. Stay calm and support your child as best as you can until professional help arrives.

Tick Bites:

Tick bites can pose several health risks, which is why it’s important to be informed about prevention, evaluation, and treatment. Ticks are small arachnids that latch onto skin and feed on blood, sometimes transmitting diseases. In Arkansas the most notable diseases transmitted by ticks include Rocky Mountain spotted fever, Erlichiosis, Anaplasmosis, Southern Tick-Associated Rash Illness (STARI), Tularemia and extremely rarely Lyme disease.

After spending time in areas where ticks thrive, such as wooded or grassy environments, it’s crucial to inspect your body and clothing for any ticks. They prefer warm, moist areas and might latch onto places like the armpits, groin, and scalp. If not removed promptly, ticks can transmit pathogens that may lead to serious health conditions.

Symptoms of a tick-borne illness typically manifest as fever, fatigue, headache, rash, or muscle and joint aches, and can show up days to weeks after a bite. Therefore, being vigilant and checking for ticks is the first step in prevention. If a tick has bitten you, it is important to remove it as soon as possible to reduce the risk of infection.

Use clean, fine-tipped tweezers to grasp the tick as close to your skin’s surface as possible and pull upward with steady, even pressure. Avoid twisting or jerking, which could cause the mouthparts to break off and remain in the skin. It is not recommended to remove a tick with your fingernails. Doing so can increase the risk of squeezing the tick’s body, which might cause it to release more potentially harmful pathogens into the bite wound. If you chose to use your fingernails anyway, grasp the tick as close to the skin as possible and remove using continuous firm pressure (5 to 10 seconds) and the tick will release its grip.

Once removed, clean the bite area and your hands with rubbing alcohol, an iodine scrub, or just soap and water. Keep an eye on the bite site for any signs of a rash or other symptoms. If you experience unusual symptoms, it is imperative to consult us for further evaluation. Depending on the situation, our physician may recommend testing for tick-borne illnesses or prescribe antibiotics as a preventive measure or as treatment if an infection is suspected. Educating yourself about the potential risks associated with tick bites and seeking prompt care when necessary can greatly aid in preventing complications associated with tick-borne diseases.

The main risk of infection by tick bites in Arkansas is Rocky Mountain Spotted Fever (RMSF). RMSF typically presents with symptoms 2 to 14 days after a tick bite. The initial symptoms often include a sudden onset of high fever and severe headache. As the disease progresses, a distinctive rash usually develops a few days after these initial symptoms. This rash often starts as small, flat, pink, non-itchy spots on the wrists, forearms, and ankles, and may spread to the trunk, hands, and feet. In some cases, the rash can darken or become more pronounced with spots.

Additional symptoms can include gastrointestinal issues such as nausea, vomiting, abdominal pain, and loss of appetite, along with generalized muscle pain. In severe cases, patients might experience confusion, changes in mental status, or other neurological problems. Early medical attention within the first week of infection is crucial for suspected cases of RMSF, as timely antibiotic treatment can prevent serious complications and death.

Lyme disease  typically begins with a rash, often in the form of an expanding ring, at the site of the tick bite called erythema chronic migraines. This rash develops over several days to weeks following an infected bite. Alongside the rash, associated symptoms may include fever, enlarged lymph nodes, headache, fatigue, and swollen, sore joints. The disease generally takes from several days to a few weeks to fully develop.

Fortunately, the ticks that carry Lyme disease are not common in Arkansas. Therefore, if you are bitten by a tick in Arkansas, you can be 99% assured that you do not have Lyme disease. However, people bitten by deer ticks in the northeastern United States should be concerned if they develop a rash as described above. Treatment is available to prevent Lyme disease. Consult us if you are concerned.

The best treatment for all of the tick-borne diseases mentioned above is prevention. A simple step taken daily can prevent these diseases. If your child has been playing in an area that might be infested with ticks, you should inspect their skin thoroughly each evening. If you find a tick, remove it with forceps (tweezers), grasping it as close to the mouth as possible and pulling it straight out. Tick-borne diseases such as Lyme disease, erlichiosis, tularemia, and Rocky Mountain spotted fever can be prevented by removing an infected tick within 12 to 24 hours of it attaching.

Wild Animal Bites:

The physician should be called immediately with any wild animal bite.