Dog bite: how to wash the wound, and why even a small one has to be seen

Just bitten by a dog, and the real question is what to do in the next ten minutes. Two things, in this order: rinse the wound under running water with soap, washing for longer than you think is enough; then be seen. According to CDC, anyone bitten by a dog or a cat should call a doctor straight away — even if you feel perfectly well.

Recognising it: a small wound does not mean a mild one

Most people who are seen late did not take the bite lightly — they concluded for themselves that their own wound was a small one. According to CDC, germs can spread from dog bites and scratches even when the wound does not look deep or serious. What decides is not whether the wound is large or small.

• A dog's teeth both tear and press deep: the opening can be tiny while the track runs deep, so rinsing water never reaches the bottom
• A scratch or a graze that breaks the skin counts too — the animal's saliva reaching broken skin is enough
• Wounds on the hand, the foot, the face or the head are more serious than elsewhere: NHS sets those four sites apart
• Young children are bitten more often than adults and tend to be hurt more badly; according to CDC most cases in young children happen in the course of ordinary daily life, with a dog the child already knows
• According to CDC, the risk of serious infection is higher in people whose immune system is weakened by cancer, diabetes or HIV, people on chemotherapy, people without a spleen and people with alcohol dependence

What to do straight away

None of the steps below needs a prescription.

1. If it is bleeding heavily, press a piece of gauze or a clean dry cloth onto the bleeding point and hold it firmly — do that first.
2. Rinse the wound under running water with soap, washing thoroughly and for a long time — for a wound that may have exposed you to rabies, CDC specifies washing for 15 minutes.
3. Cover it with clean gauze. For a small wound CDC adds applying antibiotic ointment before covering it — but that does not take the place of the appointment.
4. Be seen today and say clearly that a dog bit you: CDC notes that the person examining you may need to consult the health authorities to decide about rabies prevention.
5. Write down the time of the bite, what animal it was, and whose dog it is or whether it was a stray; if the dog has an owner, ask them for proof of rabies vaccination.
6. Do not go after the dog yourself. Report it to the local veterinary or health authority so they can deal with it and keep it under observation.

What NOT to do

• Do not use “our own dog, it is vaccinated, it is probably fine” as a reason to skip the appointment. That the dog is vaccinated is information for the doctor, not a conclusion for you
• Do not stitch a bite closed at home, do not cut it open wider, do not suck blood from it with your mouth
• Do not apply leaf poultices, powdered medicine, toothpaste, oil or grease to the wound
• Do not wait to see whether it swells or becomes infected before deciding: CDC sets the point to be seen at straight after the bite, not after the wound has got worse
• Do not buy medicine to take yourself and treat that as the end of it — whether oral antibiotics are needed is the doctor's decision after looking at the wound

The two weeks afterwards still matter

A dog bite is not only about rabies and tetanus prevention. The mouths of dogs and cats carry a group of bacteria called Capnocytophaga; according to CDC it causes infections that are rare but can be severe, reaching the bloodstream and leading to sepsis, kidney failure and gangrene — some people have needed a finger or a limb amputated.

That is why CDC sets a window for watching: within 14 days of being bitten by a dog or a cat, contact a doctor straight away if any of the signs below appear, and say clearly that an animal has just bitten you.

• Blisters around the site of the bite
• Redness, swelling, discharge of pus, or pain at the site of the bite; NHS adds a wound that is hot, leaking fluid or smelling unpleasant
• Fever
• Diarrhoea, abdominal pain, vomiting
• Headache or confusion
• Muscle or joint pain

When you must go to hospital

For that second level, CDC says to call a doctor or go somewhere that can see you straight away — quickly, but not necessarily into emergency care itself. Your part is to be seen; do not grade the levels yourself and then stay home.

What has to happen at a medical facility

Put plainly: rabies vaccine and rabies immune globulin, and any tetanus injection, are given at a medical facility rather than at home — and what gets injected is the doctor's decision after looking at the wound and hearing your account of the animal. With a sign in the box above, go in first and call afterwards.

What we can do sits around the wound: a remote consultation by video call so you can show a doctor the wound and find out whether this case needs to be seen; a doctor coming to the house to take your history and examine you, and saying clearly which cases must go into hospital; and, once a facility has dealt with it, a nurse changing dressings, removing stitches and following the healing as prescribed. If infection spreads, we work with the doctor and advise on transfer to hospital.

Sources: CDC, and the public guidance of NHS for the parts stated above. This article passes that on and does not replace being examined. Citing CDC here does not imply that CDC endorses Y Te Xanh or our services.

Need personalised advice for your loved one? Call our hotline 094 368 81 15 (24/7) — calling to ask a question or to book costs nothing. GreenCare has doctors who come to examine, nurses who carry out doctor's orders (injections, infusions, dressing changes), remote consultation by video call, and a review of the medicines you are taking; an in-depth remote consultation, or any one after the first, is a paid service. For children we take examination and acute care only — not long-term care at home, and not newborns or expectant mothers. We confirm we have staff in your area and provide transparent pricing before we begin.