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

Abstract

ABSTRACT 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.