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PostPosted: Tue Oct 29, 2013 6:42 pm 
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The world has really gone to shit since those high-altitude EMP attacks started 2 weeks ago, and it's clear no help will be coming to your area anytime soon...

14 yr old female presents with two puncture wounds on her hand (dorsal and ventral, in the region between the index finger and thumb, each about 1.5 cm deep) from a dog bite 6 hours ago. She indicates she was working in the garden pulling weeds when she was bitten. She didn't recognize the dog, and it ran off shortly after biting her. She wrapped her hand in a soiled/dirty bandana, and delayed informing anyone and continued working because, "it didn't bleed much or hurt that bad, and I didn't want my Dad to shoot the dog". The wounds aren't bleeding to any degree, no nerves/tendons/ligaments visible, normal range of motion, CRT normal on all digits, no broken bones, no apparent crush damage, but some swelling is developing around the wounds. PT is otherwise healthy, no clinical history of any significance, no allergies, and her last tetanus vaccination was 8 years ago.

WWYD? Assume you have any standard (non-Rx) and reasonably affordable wound care supplies and medical equipment, and any of the antibiotics available from fish, bird, or feed stores if you wish.


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PostPosted: Tue Oct 29, 2013 7:54 pm 
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CrossCut wrote:
WWYD? Assume you have any standard (non-Rx) and reasonably affordable wound care supplies and medical equipment, and any of the antibiotics available from fish, bird, or feed stores if you wish.

I'm limited to basic first aid in this scenario because:

1. I don't have the knowledge base to start giving meds other than OTC items (certainly not antibiotics or other types of prescription meds).
2. See number 1.

So, I would wash the punctures with plenty of warm water and soap, apply a dressing and bandages to protect the wound, and monitor for signs of infection.

Realistically, if only 2 weeks have passed since an EMP attack the entire world probably hasn't gone completely Mad Max yet. With that in mind I would also try and track down a still working hospital, clinic, or other aid station for more definitive help (e.g., tetanus booster, antibiotics, rabies treatment).

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PostPosted: Tue Oct 29, 2013 9:02 pm 
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Chop the girl's hand off and say "this is what happens when you don't report injuries right away."

Ok just kidding. wouldn't do that.

I have actually had that bite. And it doesn't really hurt, until it is opened up and cleaned out.

Which is the first thing to do, open it up and clean it really well. Since it has been left for 6 hrs this is even more critical as any little nasties in there have had time to breed and spread.

From there stitch it up and monitor it for infections. First sign of infection immediately treat with antibiotics.

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PostPosted: Tue Oct 29, 2013 10:17 pm 
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In the PAW, a known/suspected rabid bite might not be treatable by "modern" medicine. I hope someone else can "surf" better than I, not finding any good answer…

From the mayo clinic site:

http://www.mayoclinic.com/health/rabies ... -and-drugs

There is no specific treatment for rabies infection. Though a small number of people have survived rabies, the disease is usually fatal. For that reason, anyone thought to have been exposed to rabies receives a series of shots to prevent the infection from taking hold.

Treatment for people bitten by animals with rabies

If you've been bitten by an animal that is known to have rabies, you'll receive a series of shots to prevent the rabies virus from infecting you. If the animal that bit you can't be found, it may be safest to assume that the animal has rabies. But this will depend on several factors, such as the type of animal and the situation in which the bite occurred.

****

Rabies is a virus, so while antibiotics might help secondary infections, they do nothing against rabies.

Absent modern medicine, all I can see are whatever herbal anti-virals are available & immune enhancers... and prayer.


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PostPosted: Tue Oct 29, 2013 11:43 pm 
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Assuming an inability to administer prophylactic Augmentin, (and even if i could) I would have a fairly low threshold for opening the wounds up.
3 big reasons why...

1: It's the hand.
There's a reason there are orthopedic sub-specialists that deal with nothing but mitts... They're pretty damn important. Additionally, hand skin heals really well, when it's not compromised by infection.

2: It's a bite injury.
Bites are buggy injuries. Although human and feline bites are more infamous, canine bites are no joke and can lead to limb/life threatening (in austere environs) infections.

3: It's near the radial bursa.
Any wound that communicates with the radial or ulnar bursa makes me nervous. If a horseshoe abscess were to develop in this scenario, it would likely mean the loss (functional or otherwise) of the hand.

Following I&D, hand soaks in betadine solution BID and wet-to-dry's over the incision(s) until adequately healed.

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PostPosted: Thu Nov 07, 2013 9:58 pm 
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I'd clean and bandage the wound like everyone else has said. I'd also try and locate the dog if possible so I can at least observe it for any weird behavior.

The link says the rabies shots are given over a 14 day period. I've actually gone through the treatment and it took a month from start to finish. Yes, the world may not have gone to total crap in 2 weeks, but will it hold up for another month to administer the treatment if needed? Add to that, most medical facilities don't even carry the vaccine due to the cost, low usage and expiration date. So, this is a tough one if you can't find the dog and be somewhat sure it isn't carrying the rabies virus.


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PostPosted: Fri Nov 08, 2013 11:17 am 
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ineffableone wrote:
From there stitch it up and monitor it for infections. First sign of infection immediately treat with antibiotics.


Stitching up a bite wound like that is a bad idea. A dog bite can appear to be only a puncture wound, but actually have a significant crush component. Unless you surgically debride the devitalized tissue, you are setting up a bad situation for infection. Wash it well and leave it open to drain if infection does set in.

Antibiotic choice is complicated because you are possibly dealing with staph, strep or an anaerobic bacteria. That means no one magic drug.


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PostPosted: Sat Nov 30, 2013 5:39 am 
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CrossCut wrote:
The world has really gone to shit since those high-altitude EMP attacks started 2 weeks ago, and it's clear no help will be coming to your area anytime soon...

14 yr old female presents with two puncture wounds on her hand (dorsal and ventral, in the region between the index finger and thumb, each about 1.5 cm deep) from a dog bite 6 hours ago. She indicates she was working in the garden pulling weeds when she was bitten. She didn't recognize the dog, and it ran off shortly after biting her. She wrapped her hand in a soiled/dirty bandana, and delayed informing anyone and continued working because, "it didn't bleed much or hurt that bad, and I didn't want my Dad to shoot the dog". The wounds aren't bleeding to any degree, no nerves/tendons/ligaments visible, normal range of motion, CRT normal on all digits, no broken bones, no apparent crush damage, but some swelling is developing around the wounds. PT is otherwise healthy, no clinical history of any significance, no allergies, and her last tetanus vaccination was 8 years ago.

WWYD? Assume you have any standard (non-Rx) and reasonably affordable wound care supplies and medical equipment, and any of the antibiotics available from fish, bird, or feed stores if you wish.


before I start....EMP attack? wouldn't your energy/phone provider be out fixing it, i mean, shorted out electronics isn't that bad (ok, on phone/internet/tv/fridge/etc)
1. how close are you to a hospital, chances are they are still working (even if an EMP happened emergency care would still work)
a) there is a hospital, go there and see a doctor?
b) there is no hospital, go to 2.
2. is there a local doctor?
a) there is a doctor, go see him
b) there is no doctor, go to 3.
3. is there an EMS?
a)there is an EMS, go see them and they'll take it further
b) there isn't an EMS, go to 4.
4. Army?
5.Naval vessel in port?
6. relief workers?
nothing...really
monitor for infection and rabies, quarantine and prepare for possibly amputation
if all else fails, quarantine and dig grave (though if you are down here than you are going to have to shoot the dogs and burn them as well)

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PostPosted: Tue Dec 03, 2013 2:10 am 
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I'm thinking he means the kind of EMP from that new move New Dawn where North Korea uses that temporary EMP disturbance to attempt to occupy the U.S. Or at least that what's I'm going to pretend here. And assume I'm a rebel.

We keep rabbies vaccines on hand and a few different ABX for our animals, they work on people too. I'd just let her know the source of the medication and let her make the decision. I'd probably start her on an ABX if I can spare it. Whatever my books say are recommended. I'd do dressings on it that are changed daily with proper measurements and vitals all recorded. Then I'd find her some work to do, even if it's sorting good berries from old ones or something easy. I feel that a lot of times, just giving them something to keep them from thinking "I'm sick, I may be dead soon" helps wonders on the actual healing process.

This is all assuming someone has persuaded me to take this girl in, because my real life scenario doesn't include taking in 14 year old females I don't know. Or I have added people to my super secret "your allowed to bug in with me" list for whatever reason.

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PostPosted: Wed Jan 01, 2014 12:19 pm 
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Rabies wouldn't be my first concern depending on how soon a collapse had come into becoming PAW.

As others have said if it's a puncture wound (Which I get pretty much just like that once or twice a year) don't stitch it, irrigate the crap out of it and hit it with some Neosporin if any is available. I've used this to treat a few bites that didn't require medical attention, including one to my eyelid. Neosporin is annoying, but ontop of being antibacterial it's also designed to help pull foreign debris out of a wound.

My main concern would be that of tetanus, just as it is now. The same bacterium that hand around rusty surfaces hang out in the stomachs of animals.

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PostPosted: Fri Jan 03, 2014 11:39 pm 
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In the "PAW"
Assuming antibiotics (specifically Augmentin or cephalexin) not available - Super-saturated hypertonic salt bath (epsom or table) will hurt like hell, but will seriously draw out some nasties. after a good long soak, neosporin if have any left . Watch and wait.


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I don't open up dog bites, only cat bites (if they can't be irrigated well).

Irrigate with a liter or so of clean (doesn't need to be sterile) water

I don't give antibiotic prophylaxis for dog wounds. The literature is not great either, a Cochrane review basically said "not enough info." For cats it makes sense, and then you use augmentin as said already.

Soaks would probably be appropriate if you could find clean water otherwise just keep it clean and dry.

Let it heal by secondary intention. Do not close primarily. You might could do delayed primary closure, but I wouldn't until 48 hours when an infection would likely be starting to declare itself.

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From one of my threads years ago, with the best data I knew at the time. I still would follow it if I encountered the issue.

Quote:
So- first step after a bite, is making sure Cujo is no longer a threat. Goes without saying, but still worth noting if the animal ran off after a bite and could return. Next, like any tissue injury, control the bleed, particularly if it's serious. Later worries are academic if the patient bleeds out, though any compromise of a major blood vessel without higher level trauma care is quite possibly a death sentence. Once you have these issues taken care of, you will need to irrigate and debride the wound. If at all possible, have gloves, eye pro and a mask when possible, since there will be back blast from the patient as you are cleaning. Basically, this step will be lots of water under pressure, and light scrubbing of the wound area to clean out dead tissue and bacteria from the bite. Particularly if the bites were more puncture than tearing wounds, the risk of infection is present. Irrigating the wound with pressure is best accomplished with a large syringe, but field expedient options are also available, such as cleaned out squirt bottles, eye drop bottles, cammelbacks, whatever will increase the pressure a bit. Gana also noted that if you are one of the folks who packs or has access to bags of saline and administration sets, you can spike the bag and slap a BP cuff around it to increase the pressure for debridment. The advantage of this technique is that it preserves sterility much more than any of the other options. The amount of pressure you want should be borderline painful. If the patient isn't squirming some, you must not be doing it hard enough. Things to be careful of: Don't push water directly into the affected tissues. This can force the infection deeper in, and increase the chance of an infection. Make sure there is always a drain point for the fluids coming out, don't totally cover any areas with the pressurizing implement. Make sure that after you have blown anything that looks like it doesn't belong in the body out, you push at least as much fluid over the wounds to clean out what you can't see, as you did during the initial cleaning. Good wound debridement is better for preventing infections that a course of antibiotics.
JIM mentioned the possibility of using iodine/ alcohol/ Chorhexidine-digluconate or the other cleaning agents mentioned in the thread a bit further down to help clean the wound. It wasn't how I was trained, and some of the these agents are lethal to cells around the area, but if clean water is in low supply for some reason, a basic debridement followed by using a cleaning agent may be a better option than leaving the area potentially infected. Use your best judgement.
Next thing to consider is if you want a delayed closure or an immediate closure. I was taught delayed was better for puncture wounds, and would be what I prefer, but some opinions differ, particularly when cosmetic issues (IE, face bites.) are involved. For most people, Iodiform gauze to pack the wound isn't a commonly stocked item. You may have to get by with Kerlix, or in a pinch, the cleanest possible of whatever bandaging material you can create. The idea here is to let the wound heal from inside to out over the course of several days, with an oxygenated environment in the wound to help keep infection down. 19 Kilo noted that if any over the counter antibiotic ointments (triple antibiotics ointment, bacitracin, ect.) are available to help keep the chances of infection down, they certainly can't hurt and quite possibly could help.
The best single antibiotic for use after the bite is Amoxacilin (Augmentin) for a period of one week if available. About 1/5 of bites will become infected, so prophylaxis isn't a bad idea in this case, barring any other extenuating circumstances. In the case of Penicillin allergies, Doxycycline can be used as a substitute for most patients.
On the subject of rabies and tetanus: The odds of getting infected are lowered by massive irrigation, but can't be completely discounted. Currently, the rates of infection by rabies is very low, far less than one half a percent. This would start to rise in a world where the animals weren't getting their shots, though, so any wild dogs- or any wild animals in general- encountered in an PAW would have to be considered a threat before an attack could occur. The treatments for both tetanus and rabies aren't really something that the average citizen can be sitting on at home, so try to prevent bites in any case, and make sure your tetanus booster is up to date, (anytime between five and ten years in usual in the US) since you never know when you will get another chance to pick one of those up. Don't get one with less than five years since your last one though, since there is a (let me emphasize very, extremely small) chance of adverse reaction to tetanus boosters.

Questions, comments, answers?

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PostPosted: Sat Dec 24, 2016 11:49 am 
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Revisiting this one, 3 years already? Time flies... Thanks to all that responded. I just used "EMP" to represent a PAW scenario where access to advanced medical care wasn't possible and wouldn't be for the foreseeable future. YOYO essentially. Since Slugg mentioned that we might not even know this girl, let's assume it's a daughter or a niece.

So - following a thorough irrigation, cleaning, and bandaging (and I&D, betadine soaks, etc if you chose to do so), the wound is showing clear signs of a worsening infection 36 hours later. Inflammation is visibly spreading on each of the dressing changes and she says it's a "5" on the pain scale now.

You're personal pharmacy includes the ABX(s) of your choice for treatment, assuming you wish to do so or haven't started a course already, as well as the aforementioned "standard (non-Rx) and reasonably affordable wound care supplies and medical equipment". In addition, you also have a single vial, 1500 units, of equine tetanus antitoxin - labeled "for veterinary use only".

In the event you consider using the equine antitoxin, you do have oral antihistamines but the only adrenaline available is 2 Primatene mist inhalers you acquired prior to the FDA ban.

WWYD? Not trying to paint anyone into a corner with this question, as much as I'm interested in how you might treat the wound I'm even more interested in how a MD or other medical professional might weigh the risks involved here, and what factors would go into that decision making process. The risk of causing additional harm now to prevent tetanus (which may not even occur anyway), versus the risk to the patient of developing a horrific disease that you wouldn't have the means to effectively treat if it did.


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PostPosted: Sat Dec 24, 2016 1:23 pm 
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Chop her hand off, and say "this is what happens when you wrap injuries in dirty bandages and wait 6 hrs to report it."

OK kidding again. But in all seriousness, if this sort of situation did occur I would have been using the girl's injury to spread to the whole community the importance of immediate reporting of any injury pain or not worry of shooting the dog or not. In PAW with limited medical resources, quick action can be the difference between life and death.

ineffableone wrote:
I have actually had that bite. And it doesn't really hurt, until it is opened up and cleaned out.

Which is the first thing to do, open it up and clean it really well. Since it has been left for 6 hrs this is even more critical as any little nasties in there have had time to breed and spread.

From there stitch it up and monitor it for infections. First sign of infection immediately treat with antibiotics.


I will still be going with my 1st answer, of treating with antibiotics. I do have a good stock of bird and fish antibiotics in my stocks. I would have started with Amoxicillin aka Fish Mox at 1st signs of infection every 12 hrs for 10 days. If the infection was getting worse after 3-5 days and showing no signs of decreasing, then switching to SMZ-TMP (Sulfamethoxazole and Trimethoprim) aka Bird Sulfa. If this wasn't a child the 2nd option would have been Metronidazole aka Fish Zole, but this is not recommended for use with children or pregnant women.

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PostPosted: Sat Dec 24, 2016 1:32 pm 
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BTW, I think this is actually a very good WWYD. In SHTF and PAW, dogs would be a serious concern. Our tendency to think of dogs as friendly and dog's less than fearful attitude of approaching humans would make dog bites a likely problem, especially with children who likely wouldn't realize they can't pet every random dog they see. Confusion and fear of the crazy things going on in the world could make what is normally a friendly nice dog bite and attack for what seems like no good reason.

I have said in many other threads that stray/abandoned dogs will likely be a serious threat in SHTF and PAW due to our long history with them interfering with recognizing them as a threat. When they start forming packs and rewilding it will get worse. Especially if they learned to eat human corpses during SHTF.

So I think this thought exercize on what to do if a member of your group is bitten is one folks might want to really consider as highly probable. Though of course the big lesson in this might be to make sure to educate your group on dangers of dogs before the bite and be hyper aware of unknown dogs in SHTF/PAW.

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PostPosted: Fri Jan 06, 2017 10:26 am 
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GunshopGaspode wrote:
Rabies wouldn't be my first concern depending on how soon a collapse had come into becoming PAW.

As others have said if it's a puncture wound (Which I get pretty much just like that once or twice a year) don't stitch it, irrigate the crap out of it and hit it with some Neosporin if any is available. I've used this to treat a few bites that didn't require medical attention, including one to my eyelid. Neosporin is annoying, but ontop of being antibacterial it's also designed to help pull foreign debris out of a wound.

My main concern would be that of tetanus, just as it is now. The same bacterium that hand around rusty surfaces hang out in the stomachs of animals.


I think GG hit the nail one the head. a few thoughts:

The girl is 14 years old, IE school age. I would want to know if TDaP vaccine was standard for their state school vaccination list, if so she should be golden. I'd give a booster if her's was out of date and I had one available. Otherwise this is very good news

The individual puncture wound characteristics are critical here. Needle like bites will be problematic, the wider the opening, less so. I'd wash thoroughly, irrigate aggressively (if there was no chance of orthopedic involvement I would consider iodine enhanced irrigation) and then dress the wound after applying a triple antibiotic ointment if I could get it, hoping to get as much coverage as I could muster topically. She'd be on a twice daily dressing change schedule to monitor for S/S of infection.

If things were not progressing well, I would look for an antibiotic with good anaerobic coverage. I would have to assume with small punctures that with proper wound care and topical antibiotic, the issue wasn't aerobic, but a deeply trapped microorganism. Quoting medscape :

The goal of initial therapy is to cover staphylococci, streptococci, anaerobes, and Pasteurella species. Prophylactic antibiotics may be given for a 3- to 5-day course. If the wound is infected on presentation, a course of 10 days or longer is recommended.
The first-line oral therapy is amoxicillin-clavulanate. For higher-risk infections, a first dose of antibiotic may be given intravenously (ie, ampicillin-sulbactam, ticarcillin-clavulanate, piperacillin-tazobactam, or a carbapenem). Other combinations of oral therapy include cefuroxime plus clindamycin or metronidazole, a fluoroquinolone plus clindamycin or metronidazole, sulfamethoxazole and trimethoprim plus clindamycin or metronidazole, penicillin plus clindamycin or metronidazole, and amoxicillin plus clindamycin or metronidazole; a less effective alternative is azithromycin or doxycycline plus clindamycin or metronidazole.

As far as rabies goes, I would not only passively watch for the animal after getting a detialed description from the girl, but also look for signs of a local rabid animal, such as half eaten prey animals let where they aren't normally found, and other rabid animals


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Clean and bandage wait and see if she turns zombie. Otherwise keep it clean and try to keep infection from setting in.

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PostPosted: Sat Jan 07, 2017 8:14 am 
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VXMerlinXV wrote:
The girl is 14 years old, IE school age. I would want to know if TDaP vaccine was standard for their state school vaccination list, if so she should be golden. I'd give a booster if her's was out of date and I had one available. Otherwise this is very good news

Her mother states she received "at least two" DTaP vaccinations as a child, the last one at age 6. She never received Tdap or a Td booster, her mother, your sister-in-law perhaps, joined the anti-vaccine movement shortly after her last DTaP and began refusing most vaccinations for her.
VXMerlinXV wrote:
The individual puncture wound characteristics are critical here. Needle like bites will be problematic, the wider the opening, less so. I'd wash thoroughly, irrigate aggressively (if there was no chance of orthopedic involvement I would consider iodine enhanced irrigation) and then dress the wound after applying a triple antibiotic ointment if I could get it, hoping to get as much coverage as I could muster topically. She'd be on a twice daily dressing change schedule to monitor for S/S of infection.

Done at presentation.
VXMerlinXV wrote:
If things were not progressing well, I would look for an antibiotic with good anaerobic coverage. I would have to assume with small punctures that with proper wound care and topical antibiotic, the issue wasn't aerobic, but a deeply trapped microorganism.

No IV ABX available, you do have oral amox/clav as well as every other oral ABX on the medscape list. You see indications of infection starting on the 2nd dressing change and worsening signs on the 3rd, it's now 36 hours after presenting and 42 hours since being bitten.

You have 1500 units of tetanus antitoxin, veterinary equine formulation, but no epinephrine other than the Primatene Mist inhalers in the event of a severe reaction, and a tetanus prone wound (two puncture wounds, 6 hours old at presentation, garden soil contaminated). Assuming her parents are willing to agree to any recommendations you make for her treatment, and if you don't mind providing some insight into your thought processes here, what would be the primary factors that determined your decision whether or not to administer the antitoxin (following a negative 1:100/1:10 dermal reaction tests if you so choose)?


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PostPosted: Mon Jan 09, 2017 11:04 am 
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CrossCut wrote:
No IV ABX available, you do have oral amox/clav as well as every other oral ABX on the medscape list. You see indications of infection starting on the 2nd dressing change and worsening signs on the 3rd, it's now 36 hours after presenting and 42 hours since being bitten.

You have 1500 units of tetanus antitoxin, veterinary equine formulation, but no epinephrine other than the Primatene Mist inhalers in the event of a severe reaction, and a tetanus prone wound (two puncture wounds, 6 hours old at presentation, garden soil contaminated). Assuming her parents are willing to agree to any recommendations you make for her treatment, and if you don't mind providing some insight into your thought processes here, what would be the primary factors that determined your decision whether or not to administer the antitoxin (following a negative 1:100/1:10 dermal reaction tests if you so choose)?


Interesting. I would say, at this point, the scenario would entirely depend on what type of society we were living in. If I've got access to a bunch of oral antibiotics, and we are talking about my niece, I would probably go through the following:

1) Recommend her parents take her for further, more comprehensive treatment. If there is a hospital in a reasonable travel distance, dose her with oral antibiotics based on appropriate coverage and taking stock into consideration, and provide maybe a second round for the trip if they are going to be traveling for a while.

EDIT: If, like the original post said, we are 2 weeks into a strictly EMP emergency, I would assume there was still higher level of care available someplace. I can not imagine a scenario where there wasn't.

2) If there's no longer a hospital functioning regionally, I would hope by that point I had made contact with a credentialed MD, I would consult him for treatment suggestions.

3) If we are full blown World War Z, I would give her parents a list of meds, and have them try to trade chickens, bio-diesel, or pieces of eight for a full course of decent antibiotics.

The tetanus vaccine question is an interesting one. At that stage of the infective process, I would probably not administer a veterinary inoculation, here's why:

1) I can't find anything to support the use of the TDaP shot after a wound is infected. At that point we're talking about support measures for the infection, not inoculation.

2) Also, at that point, If I chose to administer the shot, I would be second guessing any negative S/S as either complications of the infection or complications of the vaccine.

3) I can not find any literature currently on the subject, so I would be hesitant to expect to find any studies in the post-disaster scenario.

4) I still stand by the "don't give meds you don't know through and through" rule. In a WWZ scenario, if I had a bunch of fish antibiotics or horse vaccine sitting around, I would seek out a subject matter expert far prior to having a presenting patient to see what I could or could not use on people. But it would not be my go-to supply unless I could confirm something.


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PostPosted: Mon Jan 09, 2017 7:23 pm 
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I would probably wash it with water and soap, sterilize it with whatever I had handy- alcohol, vinegar, hydrogen peroxide, neosporin. Then wrap it.

Other Tactic-
In the 19th century sailors far from home that were bitten by people or animals would pour the strongest (highest alcohol level ) drink they could find into the wound and then dip a burning match into each wound.After the alcohol burned out you would wrap it up. Now remember these are sulfur matches, not the modern ones you buy in the supermarket. I bet it burned like the Dickens but it seems to have worked rather well.

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PostPosted: Mon Jan 09, 2017 7:59 pm 
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Clean, debride, irrigate, then soak sterile high salt solution for a couple of hours. Then debride again in case nasties are close or loose. Then make a poultice of triple antibiotic ointment, cayenne, and fresh garlic powder. Change dressings regularly and keep putting on fresh paste of the above mixture. Avoid letting the wound dry out for a couple of days. Then air for a few hours and back under wraps for a couple more days.

You asked what I'd do. That's what I have here miles from town with dead cars and no electricity. I've used that treatment for years. I've not lost a farm animal, cat or pet yet. Some of the wounds were bites, some were from birdshot, others were through and though GSWs from city trash that moved in nearby for a while.

Keep an eye out and kill the dog first chance anyone gets.

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PostPosted: Wed Jan 11, 2017 12:02 am 
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While the equine serum May help, the typical treatment is human rabies immune globulin 20iu/kg (btw US prices will put you out several thousand dollars here) as well as the rabies vaccine on days 3, 7, and 14.
I just had titers done on my vax, going to need a booster - goodbye another 300 bucks.

Irrigation is the number one goal in any bite, keep it open to allow drainage provide ABX topical or oral as needed.
Locating and quarantining the animal would be helpful in as much as you could prepare next of kin for worst case scenario.

Up until 2004 rabies was one of only a very elite group of virii who were known to be 100 percent fatal in humans. Now there is a very radical procedure the works, sometimes (less than 30 percent), in active rabies cases. The Milwaukee protocol involves very large doses of ketamine, phenobarbatol, ribavir, and a few other high end anti-virals all administered during a chemically induced coma... not very PAW probable.


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