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Dog bites in Canadian children: a five-year review of severity and emergency department management

Published online by Cambridge University Press:  21 May 2015

Mia E. Lang  and
Terry Klassen
Mia E. Lang*
Affiliation:
Department of Pediatrics, University of Alberta, Edmonton, Alta.
Terry Klassen
Affiliation:
Department of Pediatrics, University of Alberta, Edmonton, Alta.
*
Royal Alexandra Hospital, Child Health Ambulatory Clinic, Children’s Pavilion, 2nd floor, 10240 Kingsway, Edmonton AB T5H 3V9; 780 735-4605, fax 780 735-4071, mialang@cha.ab.ca

Abstract

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Objectives:

Dog bites are a common problem. The purpose of this study was to determine the characteristics of dog bites and their emergency department management in a Canadian pediatric population, and to provide treatment and prevention recommendations.

Methods:

The charts of all children ≤ 16 years of age presenting with a dog bite to either of the 2 tertiary emergency departments in Edmonton, Alberta, between 1998 and 2002 were retrospectively reviewed.

Results:

Overall, 287 cases were reviewed; 145 boys (50.5%) and 142 girls (49.5%). The mean age was 7.4 years. The patient's face was the most frequently bitten site (58.5%, n = 168), followed by an extremity (35.5%, n = 102). Most bites required sutures (54.5%, n = 155), and 72 (25.1%) were classified as severe, based on suture number (>10 sutures, n = 69), associated fractures (n = 4), operating room repair (n = 21) or fatality (n = 1). The mean age of children with severe bites was significantly lower than children with mild bites (6.3 v. 7.8 yr, p < 0.01). Most patients were treated solely in the emergency department (84.7%, n = 243); however 44 (15.3%) were admitted to hospital and required a total of 144 days of inpatient care. Signs of infection were described in 16 cases (5.6%); of these 8 had received 2 or more prior doses of antibiotics. Public health or police notification was documented in 56 cases (19.5%), and safety or preventive discussion was documented in 3 cases (1.0%).

Conclusions:

Dog bites in Canadian children are common, often serious or even lethal, and not always managed ideally. Preventive discussion and public health contact is infrequently documented and likely seldom occurs. In addition to medical care, emergency department staff should provide and document preventive guidance and ensure involvement of public health or police when indicated.

Keywords

dog bitewound infectioninjurypediatricrabiesprevention
Type
Original Research • Recherche originale
Information
Canadian Journal of Emergency Medicine , Volume 7 , Issue 5 , September 2005 , pp. 309 - 314
Copyright
Copyright © Canadian Association of Emergency Physicians 2005

References

1.Weiss, HB, Friedman, DI, Coben, JH. Incidence of dog bite injuries treated in emergency departments. JAMA 1988;279:51–3.Google Scholar
2.Brogan, TV, Bratton, SL, Dowd, MD, Hegenbarth, MA. Severe dog bites in children. Pediatrics 1995;96:947–50.Google ScholarPubMed
3.Sacks, JJ, Lockwood, R, Hornreich, J, Sattin, RW. Fatal dog attacks, 1989–1994. Pediatrics 1996;97(6 pt 1):891–5.Google Scholar
4.Avner, JR, Baker, MD. Dog bites in urban children. Pediatrics 1991;88:55–7.Google Scholar
5.Gershman, KA, Sacks, JJ, Wright, JC. Which dogs bite? A case-control study of risk factors. Pediatrics 1994;93:913–7.Google Scholar
6.Gandhi, RR, Liebman, MA, Stafford, BL, Stafford, PW. Dog bite injuries in children. Am Surg 1999;65:863–4.Google Scholar
7.Bernardo, LM, Gardner, MJ, O’Connor, J, Amon, N. Dog bites in children treated in a pediatric emergency department. J Soc Ped Nurs 2000;5:87–95.CrossRefGoogle Scholar
8.Flores, J. Brown, J, Mackenzie, SG, Maurice, P. Innovative CHIRPP project focuses on dog bites. CHIRPP News 1997;11. Available: http://www.phac-aspc.gc.ca/publicat/chirpp-schirpt/11jul97/iss11d_e.html (accessed 2005 July 21).Google Scholar
9.Nonfatal dog bit-related injuries treated in hospital emergency departments — United States, 2001. MMWR Morb Mortal Wkly Rep 2003;52:605–10.Google Scholar
10.Boenning, DA, Fleisher, GR, Campos, JM. Dog bites in children: epidemiology, microbiology, and penicillin prophylactic therapy. Am J Emerg Med 1983;1:17–21.Google Scholar
11.Cummings, P. Antibiotics to prevent infection in patients with dog bite wounds: a meta-analysis of randomized trials. Ann Emerg Med 1994;23:535–40.Google Scholar
12.Callaham, M. Prophylactic antibiotics in common dog bite wounds: a controlled study. Ann Emerg Med 1980;9:410–4.CrossRefGoogle ScholarPubMed
13.Skurka, J, Willert, C, Yogev, R. Wound infection following dog bite despite prophylactic penicillin. Infection 1986;12:48–9.Google Scholar
14.Brakenbury, PH, Muwanga, C. A comparative double blind study of amoxicillin/clavulanate vs placebo in the prevention of infection after animal bites. Arch Emerg Med 1989;6(4):251–6.Google Scholar