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Dog Bites 101: What Parents Need To Know

Pediartician For many children, petting and playing with dogs can be fun and exciting! Even though many dogs appear friendly and harmless, it is important for parents to be aware of the risk for dog bites and other injuries! Approximately 1 percent of emergency department visits are prompted by bite wounds, and dog bites account for the overwhelming majority of these injuries. Most dog bites are caused by animals known to the child, and in 15 to 30 percent of all cases, the dog belongs to the patient’s family. Fortunately, many dog bites are minor, but more severe injuries and complications can occur. What should I do if my child is bitten by a dog? For minor scrapes and abrasions, parents should thoroughly clean their child’s wound with warm water and soap and keep it covered with an antibiotic ointment and bandage. Immediate medical care should be sought for more serious wounds and injuries, such as bites that:
  • Have broken through the skin
  • Do not stop bleeding after applying direct pressure for 15 minutes
  • May have injured bones, joints or tendons
  • Are located on the head, face, neck, hands or feet
  • Appear infected
  • Occur in children with a weakened immune system
What kind of care should I expect in the emergency department? In addition to extensive irrigation and cleansing, children with more severe injuries may require further evaluation and treatment:
  • Most children with deep cuts or lacerations will need stitches. However, wounds at higher risk for infection, such as puncture wounds, crush injuries, bites on the hands and feet, and wounds older than 12 hours (or 24 hours on the face), should not be closed with stitches, but rather left open to heal on their own. For these unrepaired wounds, parents may want to follow-up with a plastic surgeon to discuss wound healing and scar revision.
  • Children with injuries that involve the bones, joints or tendons will likely need an X-ray and surgical consult. For more complex injuries, a surgeon may decide to irrigate, explore and repair your child’s wounds in the operating room.
To prevent an infection, children with weakened immune systems, poor wound healing or high-risk wounds will receive oral antibiotics for 3 to 5 days. Additionally, because lacerations and deep wounds are at risk for a tetanus infection, a tetanus vaccination may be given to your child if he/she has not received at least 3 previous tetanus vaccines or has not received a tetanus vaccine in the preceding 5 years. If a wound already appears infected with skin redness, swelling, warmth and tenderness, additional laboratory testing and radiographic studies may be recommended to evaluate the severity and extent of the infection. Commonly, children with severe infections will be admitted to the hospital for IV antibiotics and wound care. Should I be worried about rabies? Fortunately, the incidence of rabies in the United States is extremely low (1 to 5 cases per year), and dogs and cats account for only 5percent of U.S. animal rabies. Rabies immunization is usually not needed for bites caused by healthy dogs with a known owner; however, all dog bites and scratches should be individually assessed for risk and reported to the local animal control center. They will investigate the bite case report and determine if the animal needs to be observed or euthanized for rabies testing. Just remember: Although dogs can be great companions, they are still animals and can bite! Keep your children safe by remembering these important tips:
  • Never leave infants or children alone with a dog
  • Never allow children to pet or play with a dog while he/she is eating or sleeping
  • Teach children to be careful around pets
  • Teach children not to approach strange dogs or try to pet dogs by reaching through fences
  • Educate children to ask permission from a dog’s owner before petting a dog
Dr. Katherine Leaming-Van Zandt, Pediatric Emergency Medicine Specialist