Managing serious dog bite injuries in children.

Mammalian bites account for 1% of all emergency department visits and dogs are common perpetrators. School-aged children are the most vulnerable and experience the majority of this type of trauma. Most of the cases involve a known dog and many of the attacks involve the family pet. When a child presents with a severe dog bite, the injury should be managed using appropriate assessment and intervention techniques. In some cases, conscious sedation can be used to provide amnesia, analgesia and sedation during the surgical repair. Proper preparation of the wound prior to repair will decrease infection rates. The need for tetanus and rabies prophylaxis must be evaluated in all dog bites. Facial injuries may require complex repair and reconstruction with appropriate surgical referral. Thorough discharge instructions are an important aspect of the nursing role.