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Telephone Management of Animal Bites in Clinics (12.08)

Telephone Management of Animal Bites in Clinics (12.08) - Policies, Clinical, UWHC Clinical, Department Specific, Ambulatory, Clinic Specific

12.08

12.08 Telephone Management of Animal Bites in Clinics
Category: UWHC Departmental Policy
Policy Number: 12.08
Effective Date: May 28, 2014
Version: Revision
Manual: Ambulatory
Section: Clinic Specific (Ambulatory)
 
I. PURPOSE

To provide guidelines for the assessment, treatment, documentation and reporting of animal bites reported to
UWHC clinics by telephone. (If a report of an animal bite comes through electronic messaging, such as MyChart,
the clinical staff provider should contact the patient by telephone and follow this policy).

II. POLICY

The clinical staff provider will utilize the following procedure to treat, document and follow-up on reported animal
bites involving a UWHC patient.

III. PROCEDURE
A. Clinical Management
1. In the patient's record, document the type of animal bite, the description of the bite, the care
given thus far and the patient's response. Also gather information and document the
circumstances that resulted in the animal bite for assessment of rabies risk (i.e. bitten
accidentally playing with family pet vs. unprovoked attack).
2. For wounds involving the head or face, punctures or injuries near joints where the capsule may
have been penetrated, lacerations or tears requiring sutures, deep or puncturing scratches, risk
of rabies exposure, or uncontrolled bleeding after 10 minutes of pressure, refer patient for
immediate care in the appropriate clinic during regular clinic hours or the Emergency Department
(ED).
3. Follow telephone triage manual or electronic clinical resource tools for wound care
recommendations and follow-up care.
4. Consider the following patients to be at greater risk for serious infection after an animal
bite. These patients should receive prompt medical care and/or contact their specialty care
provider or primary care provider as soon as possible.
a. Persons without a spleen or functional asplenia such as sickle cell;
b. Those receiving steroids or chemotherapy and other patients who are
immunosuppressed (transplant, etc.);
c. Patients with HIV;
d. Patients with any health care conditions that interfere with wound healing.
B. Reporting: Contact public health and/or town/city police departments to report any animal bite. Reporting
to public health is not considered a breach in confidentiality or a violation of HIPAA. A list of local health
departments is available on the Wisconsin DHS website. During off hours these reports may be taken by
local law enforcement.
C. Documentation
1. Document in progress notes any clinical response to telephone triage instructions and follow-up
recommendations.
2. Utilize Rabies Prevention Algorithm on Wisconsin DHS website to guide documentation in Health
Link.
IV. REFERENCES
A. Animal Bite Reporting Wisconsin Department of Health Services website,
http://www.dhs.wisconsin.gov/communicable/Rabies/AnimalBites.htm
B. Rabies Prevention. Wisconsin Department of Health Services website,
http://www.dhs.wisconsin.gov/communicable/Rabies/index.htm
C. Pediatric Telephone Protocols, Office Version 13
th
Edition. Barton D. Schmitt, MD, FAAP
V. WRITTEN BY


Pediatric Clinics CNS
Pediatric After Hour Clinics Manager

VI. REVIEWED AND APPROVED BY

Gregory DeMuri, MD, Pediatrics – Infectious Diseases
Ambulatory Policy and Procedure Committee
Pediatric Clinics CNS
Pediatric Clinic Managers-PAC
Clinics Managers, Internal Medicine Clinics-East, West
and WHC IM

SIGNED BY

Deborah D. Tinker, MSN RN,CENP, Director, Ambulatory Nursing