The bites from humans, reptiles, and other animals requires similar immediate aid techniques
With the June, 2016 alligator attack and death of a toddler at Disney World, I was asked about the treatment of survivable wounds.
Some of the nastiest bites come from alligators, monkeys, cats, and humans. This is due to the depth of penetration and the various bacteria carried in their mouths. Because of the complexity of the hand’s anatomy (tendons, synovial joints, blood vessels, and bones) it is more likely than other areas to get infected.
Before journeying to isolated areas:
- Familiarize yourself with any medical facilities and emergency services in the region. If not for you, you may encounter a situation in which you can save another’s life.
- Take time to educate yourself with the colors and types of poisonous reptiles and vegetation in the area.
- Have a region specific first aid kit.
- Don’t panic and get out of the danger area.
- In the third world, few animals have rabies vaccinations as they do in the U.S. and Europe. In the latter, if the owner is present, inquire if the animal has been immunized.
- Evaluate the wound. Is it a minor scrape, deep puncture wound, or a ragged cut through the flesh?
- Is the wound full of contaminates or exposed to dirty water?
- Have you had a tetanus shot in the last 5 years?
- If bit on an extremity, remove all rings and jewelry should swelling happen.
- Do not take aspirin, Naprosyn, or any other medication that could increase bleeding if the wound is large.
Minor wounds (not skin thickness):
- Wash the wound with soap and water four times a day for 3-4 days.
- Apply antibiotic cream.
- A sterile, covering bandage is optional and primarily to keep contaminated materials from entering the wound.
Deep wounds and tears:
- Apply pressure to stop bleeding especially if arterial (pulsing, bright red blood) or venous (dark, fast blood flow).
- At the first opportunity wash wound with soap and warm water for 5 minutes. You should have a needleless 5 or 10cc syringe in your medical kit to flush puncture wounds, in particular, with soapy water. Note: cat bites are particularly infectious due to the depth of even the smallest bites.
- Assess the function of joints and tendons if appropriate. Evaluation is made by taking the extremity through its full range of motion actively and passively.
- Probe the wound for any foreign material such as dirt, sand, retile teeth, shell fragments and other debris.
- Do not use hydrogen peroxide, Mercurochrome, undiluted iodine, or alcohol as it can damage fresh tissue.
- Following this initial treatment, soak the wound for 15 minutes, 3 times a day for 4 days if possible. If this isn’t possible, continue to wash with warm soapy water frequently.
- You may apply triple antibiotic ointment and cover with gauze (non-stick) to keep debris out but change at the first sign of getting it wet or contaminated.
- Bite wounds are generally better left open to drain i.e. not sutured, butterflied, or super glued.
- Watch for indications of infection that would warrant immediate treatment and/or antibiotics. These include: increasing redness, swelling, increased pain, pus, and red streaks running from the wound and up an extremity (vasculitis).
Beware: There is a risk of Tetanus (covered elsewhere) with any wound. The recommended interval for vaccination is every 10 years, BUT if it has been between 5-10 years since vaccination, you still need a booster shot if wounded. It is well to consider this prior to leaving home if you are close to the 10 year mark as it would be wise to get an earlier booster shot prior to leaving.
Beware: Monkey bites should be taken extremely seriously as they can carry, although rarely, herpesvirus. This can be a rapidly acting virus that infects the brain causing encephalitis. ANY signs of progressive headache, confusion, neck stiffness, or difficulty walking following a monkey bite requires immediate evacuation and medical evaluation.
Beware: Deep puncture wounds of the hands, the feet, and the face are areas that need to be treated soon with any signs of progressing infection.
For more read: My World the Diving Surfer https://internationaltraveladvisor.wordpress.com/2016/06/30/my-world-the-diving-surfer/