How to treat a dog's bite in children


My son was bitten by a dog. What should I do?

By Dr. Salvador Santoyo Amor

Dog bites remain a common reason for consultation in pediatric emergency services. For this reason, in this article I will address the prevention of this accident, as well as your initial first aid handling.

Is it convenient for children to have pets like dogs?

Definitely yes. The important thing is to first assess the ability of a child to take care of his dog, that is, I do not mean simply having a pet at home, but to acquire the responsibility of taking care of him 24 hours a day through his daily feeding, your toilet and, of course, your periodic visits to the veterinarian.

The fact of being able to have a pet in the pediatric age at home is a great stimulus in the development of the child, since through the animals the child learns new responsibilities such as caring, protecting, feeding and even loving his pet.

Of course, the type of dog, its breed, will be decisive in the good relationship with its owner. We all know that there are races of different sizes and behaviors, some more noble than others, more homemade, which require ample spaces and, of course, others used as a measure of protection.

There is no doubt that if there are children home, the dog should adapt to the needs of children, not adults who use their pets for other purposes, which could favor having aggressive or dangerous animals in a house where children live.

The recommended age for a child to have a dog is approximately up to 4 years, at which time a child is able to pay attention to the care of his pet, otherwise, he will be in charge of adult relatives and the relationship that It is tried to encourage between animal and child it will not be given, and if unfortunately no necessary precautions were taken when choosing the ideal pet, accidents could arise that could range from infectious parasitic problems to accidents as serious as bites.

What should I do if a child is bitten by a dog?

The first thing to do is vigorously wash the wound with water and toilet soap. If possible, place the affected limb under the water stream and with a sponge, carve the wound even though it bleeds a little more.

Of course, this procedure will favor the pain and discomfort of the injured, but the effect of mechanical washing before the bite of a dog is very important, since what we are trying to do is remove all the saliva of the animal that could be in contact with the wound of the child.

In this way we avoid infectious processes that can range from cellulite to rabies, which is a deadly infection in humans.

After the toilet, it will be convenient to administer an analgesic child orally, preferably indicated by a doctor. The wound, if possible, may be covered with sterile gauze, bandages or, failing that, some clean canvas to transfer the child to a hospital as soon as possible.

To go to the medical service, the following information will always be very useful:

1) Child vaccination card.

2) Dog vaccination card.

3) Description of the accident, reason that originated it.

4) Current condition of the aggressor animal.

At the site of the accident the attacking dog also deserves our attention, since far from hurting it we must catch it and place it in some yard where its food and water can be offered, this will be of vital importance, since the animal must be kept stored On this site, without contact with other animals, for a period of 12 forced days, during which time their behavior will be evaluated to determine if at the time of having bitten the child this animal was involved with rabies infection.

It should be mentioned that a dog does not survive more than 7 days with the rabies infection.

During this period of surveillance before the evidence of behavior changes not caused by external agents in the animal, the treating physician of the affected child should be notified immediately.

What is the medical management of a dog bite?

Upon arrival at a hospital, the affected limb must be washed again immediately. According to the extent of the wound, it could be a wash with antiseptic substances in the emergency department or, if necessary, it could even indicate a surgical wash, referring to sedation of the patient taking care of the airway and performing the mechanical washing in an operating room

In most cases, dog wounds should not be sutured, but in individual cases, either due to their large extension or location on the face, after surgical washing as mentioned, surgical repair will be carried out through sutures.

Obviously, the vaccination status of the child will be evaluated and if it is suspected that it is incomplete, it will be vaccinated against tetanus.

On the other hand, every child bitten by a dog is started prophylactically antibiotic therapy, evaluating its continuation 72 hours after starting it, and according to its evolution, it will be determined to continue or suspend it.

Finally, the need or not to apply rabies vaccine and gamma globulin should be evaluated. These products will not be applied to every child bitten by dog. Its application will be determined by the following points:

1) Unknown dog.

2) Dog known, but without vaccines.

3) Face wound (the condition of the dog and the extent of the wound should be evaluated).

It is worth mentioning that the rabies vaccine that is currently used is noble in terms of adverse reactions, there are five applications according to an established scheme and it is applied intramuscularly in the deltoid (arm muscle).

To conclude, I will only mention that prevention is the fundamental tool to avoid accidents as serious as a dog bite in the face of a child.

We must foster the relationship of children with their pets, but with certain rules that we must respect.

Pediatrician attached to the Emergency and Toxicology Service
Federico Gуmez Children's Hospital

If you want to see a pediatrician of the medical body of the Children's Hospital of Mexico call 5 228 9917 ext. 1241, where you will receive an answer to your questions

Tips for acting if a dog bites our child

The dog is probably the most desired companion animal, the most affectionate, the most faithful, man's best friend, they say. In addition, dogs are a constant wake-up call for children. That warm stuffed animal that plays, runs and makes funny faces is so 'achuchable' that it is impossible to resist the temptation to give her a caress.

And the dogs respond. They have a sixth sense to realize that this brat that pulls his hair and skunk, is nothing more than a baby, and should be pampered like any other puppy. But nevertheless, sometimes dogs bite. By mistake, by defense, by fear, but they bite. And parents should be clear about what to do.

What to do if a dog bites our son

1. First, don't hit the dog as immediate revenge. This attitude is worthy of primitive beings and improper of a rational being. In addition, it is very likely that the animal is not to blame, and our violence will only generate more violence, so keep calm.

2. Try to clarify the facts: It is necessary to know the circumstances in which the bite took place. It is necessary to determine if it was an accident while the child played with the dog, which is the most frequent situation, or if the bite was without provocation, data that could reflect the probability of rabies infection.

3. It is obligatory to ask and know the vaccination status, both of the victim and the aggressor, as well as the clinical status of the dog at the time of the attack. It is also ideal that there is the possibility of examination and monitoring of the dog by a veterinarian for at least ten days.

4. Attend our children: Wash the wound as soon as possible with soap and water, cleaning all visible dirt. In case of involvement of arms or legs, it is recommended to raise the affected limb and immobilize it.

5. In any case, it is recommended to go to the pediatrician from the health center or to the pediatric emergency department, as surgical advice, x-rays and / or prescribing antibiotics may be necessary.

How dog bites affect children

Dog bites are, by far, the most frequent. Luckily, the possibility of infection of this type of bites is low (5-15%). In adolescents and older children, the extremities are the most affected regions. However, in infants and young children, injuries to the face and neck are more frequent, and always need assessment by a pediatric surgeon.

In theory, and in general, the most dangerous dogs are those trained for defense or attack. Some breeds, such as pit bull, doberman or rottweiler, can lead to more serious bites, mainly due to the characteristics and strength of their jaws, and not so much because of their reputation as violent dogs. If a dog is aggressive, the first one to study is the owner, not the dog.

How to avoid dog bites in children

We should not be afraid of dogs, especially since our fear will also be transmitted to our children. Let's not prevent them from approaching, playing with them and caressing them for hours. Let's show them that when they move their tails and bark they are usually happy, but that other signs such as low-pitched grunts or if you raise your lips and show your teeth, they can be signs of aggressiveness, and it may be convenient to move away prudently.

We must also indicate our children It is not appropriate to disturb dogs while eating or holding objects in their mouths They consider their property, as well as try to displace them from their resting place. In the case of stray dogs, or in countries where rabies cases are more common, prudence should mark our approach to these faithful friends. And if there is bad luck, in case of bite, consult your pediatrician.

Road to security

If a cat or dog bites you, you should:

  • Wash the wound gently with soap and water.
  • Apply pressure with a clean towel on the injured area to stop any bleeding.
  • Apply a sterile bandage over the wound.
  • Keep the wound elevated above your heart to prevent swelling and infection.

Serious bites may require additional medical attention. Call your doctor if:

  • Your bite becomes infected. Symptoms include redness, swelling, heat and pus. You can also develop a fever.
  • Bleeding does not stop after 15 minutes of pressure.
  • You think you have a broken bone, nerve injuries or serious injuries.
  • You have diabetes or a condition that weakens your immune system. This includes liver or lung disease, cancer or AIDS.
  • His last tetanus shot was more than 5 years ago. If so, you may need a booster shot.
  • He was bitten by a wild or stray animal.
  • He was bitten by a pet with unknown vaccination status.

The treatment for cat and dog bites varies. It will depend on the situation and the severity of your injury. Here are some things your doctor could do.

  • Examine your wound for damage to nerves, tendons or bones.
  • Examine for signs of infection.
  • Clean the wound with a special solution and remove any damaged tissue.
  • Use sutures to close your wound. However, open wounds often heal faster and are less likely to become infected.
  • Prescribe an antibiotic to prevent infection.
  • Give an injection against tetanus if your last vaccine was more than 5 years ago.

Most people who suffer from cat and dog bites do not need rabies vaccine. The disease is uncommon in cats and dogs in the United States. However, it is common in wild animals, such as raccoons, skunks, bats and coyotes. If you know the owner of the cat or dog that bit you, ask for their health records. They will show you the pet's vaccination records. It may be a good idea to isolate the pet and monitor it for signs of rabies. If the animal shows such signs, a veterinarian will perform a test for the disease. If it is positive, you will need a series of rabies vaccines. You will get 2 vaccines immediately and 3 more vaccines over a period of 14 days.

If the cat or dog that bit you is stray, call animal control. They will try to find the animal to perform a rabies test. In this situation, your doctor may or may not recommend rabies vaccines. If necessary, report your bite incident to the appropriate authority. It could be animal control or the police.

Your doctor may ask you to follow up with them. If your wound worsens or begins an infection, call your doctor immediately. You may need to see a specialist if your injury is serious.

Aspects to consider

There are many things that can be done to help prevent cat and dog bites.

  • Choose your family pet carefully. Be sure to keep your vaccinations up to date.
  • Never leave a small child alone with a pet. They often do not know how to treat the pet. This can cause the pet to get angry and bite him.
  • Do not try to separate animals in the middle of a fight. They can bite you while you try to do it.
  • Avoid contact with animals that are sick or have unknown vaccination records.
  • Do not disturb animals alone while eating. Animals are usually protectors of their food.
  • Keep your pets on a leash when they are in public.

Questions to ask your doctor

  • What are the signs or symptoms of rabies?
  • When should I involve the authorities?
  • What should I do with my family pet if it bites someone?

Last Updated Version: July 14, 2017

This article was contributed by Editorial Staff

Copyright © American Academy of Family Physicians

This information provides an overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this topic.

Wound care

Due to the risk of infection, you should go to the health care provider within 24 hours in case of any bite that breaks the skin. If you are caring for someone who was bitten:

  • Calm and reassure the person.
  • Wash your hands well with water and soap before treating the wound.
  • If the wound is bleeding, wear latex gloves if you have them.
  • Wash your hands again after this.

To take care of the wound:

  • Stop bleeding from the wound by applying direct pressure with a clean, dry cloth.
  • Wash the wound. Use a mild soap and hot running water. Rinse the bite for 3 to 5 minutes.
  • Apply an antibacterial ointment to the wound. This can help reduce the chances of infection.
  • Put on a sterile bandage.
  • If the bite is in the neck, head, face, hand. fingers or toes, call the provider immediately.

In case of deeper wounds, you may need stitches. Your provider can give you a tetanus shot if you have not had one in the last 5 years. You may also need to take antibiotics. If the infection has spread, you may need to receive antibiotics intravenously (IV).

When to call animal control

You should call animal control or the local police if you bite it:

  • An animal that behaves in a strange way.
  • An unknown pet or a pet that has not received the rabies vaccine.
  • A stray or wild animal.

Tell them how the animal is and where it is. They will decide if the animal should be captured and isolated.

Possible complications

An animal bite is more likely to become infected in people who have:

  • Weakened immune systems due to medications or disease
  • Diabetes
  • Vascular disease of peripheral arteries (atherosclerosis or poor circulation)

Receiving a rabies vaccine immediately after being bitten can protect you from the disease.

How to prevent animal bites

To prevent animal bites:

  • Teach children not to approach strange animals.
  • DO NOT provoke or disturb animals.
  • DO NOT approach an animal that is acting strangely or aggressively. You may have anger. DO NOT try to catch the animal yourself.

When to call the doctor

Wild animals and unknown pets could carry rabies. If you have been bitten by a wild or stray animal, contact your provider immediately. Check with you within 24 hours in case of any bite that breaks the skin.

Call your provider or go to the emergency room if:

  • There is swelling, redness or pus that comes out of the wound.
  • The bite is on the head, face, neck, hands or feet.
  • The bite is deep or large.
  • You observe muscle or exposed bone.
  • You are not sure if the wound needs stitches.
  • The bleeding does not stop after a few minutes. In case of severe bleeding, call the local emergency number (911 in the United States).
  • You have not received a tetanus vaccine in 5 years.

How should we relate to dogs

As much as we think we know a dog, it is necessary to always supervise when our children are in contact with a foreign pet. To reduce the risk of bites, it is convenient to teach children the following safety rules:

  • Always ask the owner whether or not the dog can be petted.
  • Wait for the dog to see you and smell you before petting him.
  • Once you can caress him, do it with your fingers together and slowly.
  • Do not disturb the dog.
  • Do not approach or leave a dog that is running.
  • If an unknown dog approaches you, keep calm, do not look directly into their eyes, or run away.
  • If a dog tries to bite you, place any object between its body and that of the dog. If the dog makes you fall, make a ball covering your face and stay still. Ask for help.
  • Do not try to stop animals when they are fighting.
  • Leave sick, injured or dead animals alone, and call the local Animal Control Department.
  • Leave wild animals alone.

How a dog's master should act

If you already have a dog, make sure you keep your vaccination schedule up to date and take it to the vet regularly. Consider enrolling the dog in a training center or school to favor its sociability and obedience, which will greatly reduce the chances of biting someone.

When you take the dog for a walk, always take it on the leash to control it. Carefully supervise your child when he is related to the dog and never leave a baby or a small child (up to two and a half years old) alone with the family pet.

Even if you are used to living with dogs at home, make sure that your child understands some rules for relating to them:

  • Never squeeze a dog too hard, do not throw it in the air, do not lie on it or jump on it.
  • Do not annoy a dog or stretch their ears or tail.
  • Do not disturb a dog while eating, sleeping or taking care of its young.
  • Never remove a toy or bone from a dog, or play fighting with it.
  • Never feed a dog using your fingers. Always put the food on the palm of the hand while keeping all the fingers well together.
  • Never corner a dog against a corner.

How to act before a dog bite

Treatment depends on the location of the bite, of the general state of health of the victim and whether the dog is vaccinated against rabies.

The basic principles of care are the following:

  • Seek immediate medical supervision.
  • Wash and clean the wound with soap and plenty of water.
  • Practice a primary wound suture if the risk of infection is low.

Try to provide accurate information on what happened in order to help your pediatrician determine the risk of infection and the type of treatment:

  • Name and place of residence of dog owners.
  • If the dog carries, or not, its daily vaccination program.
  • If the attack has been, or not, provoked. This helps the doctor to know if the dog could be sick, which, in turn, will affect the treatment to follow.
  • The degree of updating of your child's vaccination program and his chronic medical history.

Access to the query source:

Animal bites Medline Plus [Date of consultation: 10/16/2017]

Treatment for animal bites. Healthy Children [Date of consultation: 10/16/2017]

Animal bites World Health Organization. [Date of consultation: 10/16/2017]