Hutson H R, Anglin D, Pineda G V, Flynn C J, Russell M A, McKeith J J
Department of Emergency Medicine, Brigham and Women's Hospital, Harvard Medical School Boston, Massachusetts, USA.
Ann Emerg Med. 1997 May;29(5):637-42. doi: 10.1016/s0196-0644(97)70253-1.
To quantify the number of individuals bitten, the number of bites per patient, and the types of injuries and complications caused by law enforcement K-9 dog bites treated in the Jail Ward Emergency Department of the Los Angeles County-University of Southern California Medical Center. These variables were compared before and after a change in K-9 police policy from the "bite-and-hold" to the "find-and-bark" technique or stricter controls were instituted over the K-9 teams.
A retrospective chart review of all patients in police custody with K-9 dog bites who presented to the Jail Ward ED between January 1, 1988, and December 31, 1995, was conducted. Demographic data of patients with K-9 dog bites, the number and location of bites, complications, procedures performed, and management of bites were recorded and compared between the periods 1988-1991 (before the policy changes) and 1992-1995 (after the changes).
Between 1988 and 1995 790 in-custody patients were treated for K-9 dog bites in the Jail Ward ED; 705 charts were available for review. Nearly all the patients (98.6%) were male, with a mean age of 25; 85.0% were Hispanic or black. More than half (57.2%) sustained three or more bites, mainly to the extremities. Complications ensued in 19.3%: vascular in 7.0%, infection in 5.0%, fracture or cortical violation in 4.0%, nerve injury in 1.9%, and tendon injury in 1.1%. Half (49.9%) were hospitalized, with a median stay of 3 days. After the change in K-9 policy, the number of patients with K-9 dogs bites presenting to the Jail Ward ED decreased from 639 (1988-1991) to 66 (1992-1995). The proportion of patients who sustained three or more bites decreased from 58.4% to 45.5%. The rate of vascular complications decreased from 7.5% to 1.6%, the rate of fractures decreased from 2.4% to 0, and the rate of cortical violations increased from 1.4% to 6.3%. The proportion of patients hospitalized decreased from 52.0% to 33.8%.
K-9 dog bites are associated with significant injuries and complications. In this study, changes in law enforcement K-9 policy contributed to a significant decrease in the overall number of individuals bitten, the number of injuries and complications, and the proportion of patients hospitalized.
量化洛杉矶县 - 南加州大学医学中心监狱病房急诊科收治的因执法用警犬咬伤的个体数量、每位患者的咬伤次数，以及所导致的损伤类型和并发症。在执法用警犬政策从“咬并控制”改为“搜寻并吠叫”技术或对警犬队实施更严格管控前后，对这些变量进行了比较。
对1988年1月1日至1995年12月31日期间被警方拘留且因警犬咬伤而到监狱病房急诊科就诊的所有患者进行回顾性病历审查。记录并比较了1988 - 1991年（政策改变前）和1992 - 1995年（政策改变后）期间警犬咬伤患者的人口统计学数据、咬伤的数量和部位、并发症、所进行的操作以及咬伤的处理情况。
1988年至1995年期间，监狱病房急诊科共治疗了790名被警方拘留的警犬咬伤患者；其中705份病历可供审查。几乎所有患者（98.6%）为男性，平均年龄25岁；85.0%为西班牙裔或黑人。超过一半（57.2%）的患者遭受了三次或更多次咬伤，主要在四肢。19.3%的患者出现了并发症：血管损伤占7.0%，感染占5.0%，骨折或皮质损伤占4.0%，神经损伤占1.9%，肌腱损伤占1.1%。一半（49.9%）的患者住院，中位住院时间为3天。警犬政策改变后，到监狱病房急诊科就诊的警犬咬伤患者数量从639例（1988 - 1991年）降至66例（1992 - 1995年）。遭受三次或更多次咬伤的患者比例从58.4%降至45.5%。血管并发症发生率从7.5%降至1.6%，骨折发生率从2.4%降至0，皮质损伤发生率从1.4%升至6.3%。住院患者比例从52.0%降至33.8%。
警犬咬伤会导致严重的损伤和并发症。在本研究中，执法用警犬政策的改变使得被咬伤个体的总数、损伤和并发症的数量以及住院患者的比例显著下降。
