Staff should be aware of the special management complications these injuries may present
Many hospitals have found the use of law enforcement K-9 dogs to be extremely effective deterrents to violence. At the same time, according to a recent study, emergency physicians should be aware that patients who have been bitten by K-9 dogs will present with more serious complications than patients with other types of bite wounds.1 Injuries from K-9 dogs are often more severe than other dog bites, says H. Range Hutson, MD, the study’s principle author and clinical research director for the department of emergency medicine at Brigham and Women’s Hospital, Harvard Medical School in Boston.
"You need to know what kind of injuries to look for with these dogs and be concerned about bites to the neck, throat, and face," he notes. "The bite forces are what you have to look out for." An untrained German shepherd can bite with a force of 150 to 200 pounds per square inch, but that number increases to 450 to 1500 pounds per square inch with trained law enforcement dogs, he says. The study found that when local law enforcement train their dogs to "bite and hold," instead of "find and bark," injuries are more severe. "There are clearly a lot more injuries from the bite and hold technique," says Hutson.
The vast majority of people bitten by K-9 dogs will have at least one high-risk wound, Hutson says. "In our study, there were frequent vascular injuries to the upper extremities. When managing these wounds, you also need to keep in mind the possibility of a fracture and the degree of soft tissue injuries these people will sustain," he says.
When a patient is brought into the ED by law enforcement after being bitten by a K-9 dog, a toxic screen may also be warranted, he says. "About a third of the people in our study were also substance abusers. The patient could be addicted, and you may have withdrawal issues to deal with," says Hutson. "You also need to get an idea of their medical history. If a patient is diabetic and bitten by law enforcement dog, you have to be concerned with infection and complication rates and making sure they are on antibiotics secondary to their wounds."
1. Hutson HR, Anglin D, Pineda GV, et al. Law enforcement K-9 dog bites: Injuries, complications, and trends. Ann Emerg Med 1997:29: 637-642.