Bitten
Multisystem Processes & Disorders
0
{"ops":[{"insert":{"image":"\/storage\/case-images\/cs\/M26_F1.jpg"}},{"insert":"\n\n"},{"insert":"It is a lovely spring morning.\r\n \r\nYou gaze out of the window of the rural health clinic (RHC) to which you\u0027ve been assigned. The weekend starts tomorrow, and a fishing trip awaits!\n"}]}
1
{"ops":[{"insert":{"image":"\/storage\/case-images\/cs\/M26_F2.jpg"}},{"insert":"\n\n"},{"insert":"Your first patient of the day, 17-year-old Daryl, arrives at the clinic. He is accompanied by a friend, and both of them look quite anxious. \r\n \r\nHe has a cloth wrapped around his left hand and is clearly in pain.\n"}]}
2
{"ops":[{"insert":"\u0022The neighbor\u0027s dog bit him, doctor,\u0022 the friend explains. You notice multiple puncture wounds on his right hand as well.\r\n\r\nYou quickly initiate constant irrigation over several minutes to cleanse the wound, while racking your brains for the treatment protocols for animal bites.\n"}]}
3
{"ops":[{"insert":"Having recalled the recommended management, you first inquire about the vaccination status of both the patient and the animal in question.\r\n \r\n\u0022I think I may have received a tetanus shot previously, but I\u0027m not too sure,\u0022 he responds. \u0022I\u0027ve known the dog awhile and she seems fine, pretty healthy, but I really couldn\u0027t tell you whether she\u0027s been vaccinated.\u0022\n"}]}
4
{"ops":[{"insert":{"image":"\/storage\/case-images\/cs\/M26_F5.jpg"}},{"insert":"\n\n"},{"insert":"What do you do next?\n"}]}
1. Cleanse and irrigate the wound
2. Cleanse and irrigate the wound and administer prophylactic antibiotics
3. Refer him to a tertiary care hospital
6
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9
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7
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5
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8
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