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Bite, Human, Emergency Medicine

Daniel T. Wu Reviewed 06/2017
 


Basics

Description

  • 3rd most common bite (after dogs and cats)

  • Most bites (up to 75%) occur during aggressive acts.

  • 15–20% are related to sexual activity (love nips).

  • 2 types of bites:

    • Occlusional bites: La...

Diagnosis

Signs and Symptoms

  • Location:

    • Upper extremities (60–75%)

    • Head and neck (15–20%)

    • Trunk (10–20%)

    • Lower extremities (∼5%)

  • Frequent complications:

    • Cellulitis

    • Serious deep-space infections (septic arthrit...

Treatment

Pre-Hospital

Control bleeding with direct pressure. 

Initial Stabilization/Therapy

ABCs: Ensure patent airway and adequate peripheral tissue perfusion 

Ed Treatment/Procedures

  • Wound irrigation:

    • Co...

Follow-Up

Disposition

Admission Criteria

  • Infected wounds at presentation

  • Severe/advancing cellulitis/lymphangitis

  • Signs of systemic infection

  • Infected wounds that have failed to respond to outpatient (PO) ...

Pearls and Pitfalls

  • Examine the deepest part of clenched-fist bites while putting the fingers through full range of motion to check for extensor tendon lacerations and joint violation.

  • Obtain hand cons...

Additional Reading

  • Broder  J, Jerrard  D, Olshaker  J, et al. Low risk of infection in selected human bites treated without antibiotics. Amer J Emerg Med.  2004;22(1):10–13.

  • Brook  I. Microbiology...

Codes

ICD9

  • 879.8 Open wound(s) (multiple) of unspecified site(s), without mention of complication

  • 882.0 Open wound of hand except finger(s) alone, without mention of complication

  • 882.1 Open wound of hand...

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