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Case Study
A 3-year-old girl arrives at the clinic accompanied by her parents. The family has a dog that bit the girl, and she has bite wounds on her hand and ear. The ear is torn, but it is not actively bleeding. The hand has three puncture wounds in the soft tissue, none of which are actively bleeding. However, bruising is noted on the hand around the area of the puncture wounds. The parents report that the bite occurred within the last 45 minutes.
The girl is alert and oriented but appears frightened and in pain. She cries when her hand or ear is touched. Her vital signs are: temperature 37°C, pulse 120 beats per minute, respiratory rate 24 breaths per minute, blood pressure 90/60 mmHg, oxygen saturation 98% on room air. She has no allergies and is up to date on her immunizations. She has no past medical history or current medications.
The physical exam reveals a 2 cm laceration on the upper part of her left ear, with some tissue loss and irregular edges. There is no active bleeding, but there is dried blood and some dirt on the wound. There is no sign of infection or inflammation. The ear canal is intact and there is no hearing loss. The hand has three puncture wounds on the palmar aspect of the index, middle and ring fingers of the right hand. The wounds are about 0.5 cm in diameter and 1 cm deep. There is bruising around the wounds, but no active bleeding or signs of infection or inflammation. The hand has normal range of motion and sensation.
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