Dog Bite Management in OPD: Step-by-Step Guide
Dog bite is a common presentation in outpatient departments and emergency rooms. Prompt and correct management is crucial to prevent rabies a disease that is almost always fatal once symptoms appear.
This guide provides a practical, step-by-step approach to dog bite management in OPD, aimed at interns, medical officers, and primary care doctors.
Step 1: Immediate Wound Care (Most Important Step)
Wound care should begin immediately, even before vaccination.
- Wash the wound thoroughly with running water and soap for 10–15 minutes
- Use antiseptics such as povidone-iodine or chlorhexidine
- Avoid irritants like chilli, turmeric, lime, or chemicals
- Avoid tight bandaging
Do not delay wound washing it significantly reduces viral load.
Step 2: Assess Rabies Exposure Category
- Category I: Touching or feeding animals, licking on intact skin
- Category II: Minor scratches or abrasions without bleeding
- Category III: Bites or scratches with bleeding, licks on broken skin, saliva exposure to eyes or mouth
Correct categorization determines the need for vaccine and immunoglobulin.
Step 3: Start Anti-Rabies Vaccine (ARV)
Anti-rabies vaccine should be started as early as possible.
- Category II: ARV required
- Category III: ARV required + Rabies Immunoglobulin (RIG)
The commonly used intramuscular regimen is 0-3-7-28.
👉 Use this tool to calculate exact vaccine dates:
ARV Schedule Calculator (0-3-7-28)
Step 4: Rabies Immunoglobulin (RIG)
RIG is indicated in:
- All Category III exposures
- Patients not previously vaccinated
RIG should be infiltrated locally around the wound as much as anatomically feasible.
Step 5: Tetanus Prophylaxis
- Give TT/Td if vaccination history is unknown or last booster > 5 years
- Give TIG for dirty wounds with incomplete or unknown immunization
When to Refer a Dog Bite Patient?
Refer the patient to a higher center if:
- Severe Category III exposure with multiple deep wounds
- Bites on face, neck, hands, or genitals
- Need for surgical wound management
- RIG not available at your center
Common Mistakes in OPD Dog Bite Management
- Skipping proper wound washing
- Incorrect exposure categorization
- Failure to give RIG in Category III bites
- Delaying ARV initiation
- Primary suturing without adequate care
Key Takeaway
Dog bite management requires systematic assessment, immediate wound care, timely ARV initiation, and correct use of RIG and tetanus prophylaxis.
Use clinical tools to avoid date calculation errors and ensure patient compliance.
👉 Use this tool to calculate exact vaccine dates:
ARV Schedule Calculator (0-3-7-28)
Disclaimer: This content is for educational and clinical reference only. Always follow national guidelines and institutional protocols.
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