2023年《安全常识灾害防范》之动物伤害后的医疗处理.docx

动物伤害后的医疗处理 动物伤害后的医疗处理 Medical Treatment after being hurt by Animals 狗猫鼠伤害Hurt by dog, cat and mouse 1    现场处理：如果被狗猫鼠等动物咬伤或抓伤，重要的是做好现场的应急处理工作。 Site treatment: if being bitten or clawed by dog, cat and mouse, it is important to do the site emergency treatment. l 但凡狗、猫、鼠等动物咬伤，不管是疯狗、病猫还是正常的狗、猫（有相当多的一局部正常的狗、猫的唾液中带有狂犬病毒），立即就地、彻底冲洗伤口。咬伤部位在四肢时，可暂结止血带，用生理盐水或清水冲洗伤口。   If being bitten by dog, cat, mouse and such animals, not matter rabid dog, sick cat, or normal dog or cat (quite a bit of normal dogs and cats have rabies virus in their saliva), you shall wash the wound thoroughly in that site immediately. If the bitten position is in extremities, the tourniquet can be used temporarily, and the wound shall be washed by physiological saline or clean water.   l 冲洗伤口一是要快，二是要彻底，三是伤口不可包扎。处理伤口分秒必争，以最快速度把沾染在伤口上的狂犬病毒冲洗掉。因为时间一长病毒就进入人体组织，沿着神经侵犯中枢神经，置人于死地。由于狗、猫咬的伤口往往外口小，里面深，这就要求冲洗时，尽量把伤口扩大，让其充分暴露，并用力挤压伤口周围软组织，而且冲洗的水量要大，水流要急，最好是对着自来水龙头急水冲洗。   Washing the wound shall be firstly quick, secondly complete and thirdly the wound shall not be bound up. Not a second is to be lost for wound treatment, and wash the rabid virus from the wound at the fastest speed. Because in case of a long time, the virus will intrude into human body tissue, go along the nerves to encroach the nervous centralis and kill the person. Due to the small outside and deep inside of bitten wound by dog or cat, it requires widening the wound as big as possible to explore the wound sufficiently when washing, and extruding the soft tissue around the wound and the washing water shall be big as possible with rapid flow, it’s better to wash the wound by tap water cock with rapid flow.   特别要注意的是，如果被狗、猫、鼠咬伤，伤口不作任何处理是错误的，错上加错的是不仅伤口不冲洗，而是涂上红药水包上纱布更有害，切忌长途跋涉赶到大医院求治，而是应该立即就地、彻底冲洗伤口，在24小时内注射狂犬疫苗。    Special note: no treatment for the wound bit by dog, cat and mouse is wrong, and more harmful wrong treatment is not to wash the wound, but wipe with mercurochrome and bind up by gauze. It shall not go long way to large hospital for treatment, but shall wash the wound thoroughly at that site immediately, and inject rabies vaccine within 24 hours.   2    诊所及医院处理： Clinic and hospital treatment: 伤口经过反复冲洗后，到诊所作进一步的处理，伤口还要认真冲洗、消毒，联系金山医院作进一步救治。 After washing the wound repeatedly, go to the Clinic for farther treatment, and the wound still needs careful washing, disinfection, and then contact with Jinshan Hospital to do farther treatment. 第一步 及时正确伤口处理 The first step correctly treat the wound in time l 应尽快用3%～5%肥皂水或0.1%新洁尔灭反复冲洗至少半小时，肥皂水与新洁尔灭不可合用。并挤出污血。 Shall immediately wash the wound repeatedly by 3%～5% soapy water or 0.1% bromo—geramineum at least for half an hour, the soapy water could not be used together with the bromo—geramineum. And squeeze out the smear blood. l 冲洗后用70% 酒精擦洗及浓碘酒反复涂拭。 Swab down the wound by 70%alcohol and embrocate by thick iodine repeatedly. l 伤口一般不予缝合或包扎。除了个别伤口大，又伤及血管需要止血外，一般不上任何药物，也不包扎，因为狂犬病毒是厌氧的，在缺乏氧气的情况下，狂犬病病毒会大量生长。 In general, the wound shall not be oversewed or bound up. Except the wound is very big, injuries the blood vein and needs hemostasia, normally do not apply any medical, neither binding up. Because the rabies virus is anaerobic, and it will largely grow under the condition of oxygen shortage. l 必要时使用抗生素和精制破伤风抗毒素。 If necessary, apply antibiotic and purified tetanic antitoxin.  l 局部伤口处理愈早愈好，即使延迟1～2天甚至3～4天也不应无视局部处理，此时如果伤口已结痂，也应将结痂去除后按上法处理。 It will better to treat the partial wound as early as possible, though it was delayed 1～2 days even 3～4 days, the partial treatment shall not be ignored, and if the wound has scabbed at this time, it shall get off the scab and treat the wound according to the above method. 第二步 进行狂犬疫苗和抗狂犬病免疫血清免疫接种 The second step  inoculate the rabies vaccine and rabies antiserum 世界卫生组织（WHO）推荐动物咬伤分类、建议的暴露类型和治疗方法见表 See the following table for the explosion types and medical methods on animals’ bite sorts and suggestion recommended by World Health Organization (WHO)     分类 Sort 与动物接触类型 Contact type 推荐治疗方法 Recommended medical method I 触摸或喂养动物，舔及完整皮肤 Touch or feed animals, be lapped the unbroken skin 如无皮肤破损，无需采取任何措施 If no skin broken, no need to take any measures II 无流血，多为轻度擦伤或抓伤 No blood, mostly light abrasion or claw 立刻接种疫苗 Inoculate the vaccine immediately III 一处或多处皮肤穿透性咬伤,唾液污染黏膜 One or several skins are penetrability bite, the saliva polluted the mucous membrane 立刻使用抗狂犬病血清和接种疫苗 Apply rabies antiserum and inoculate vaccine immediately   目前上海市的处理原那么：一旦被犬特别是可疑犬咬伤后，立刻接种狂犬病疫苗，全程接种疫苗（0、3、7、14、30天共5针）。被犬咬伤头面、颈部、上肢、胸背部及其它部位的多处或严重咬伤者立刻接种疫苗，并应用抗狂犬病血清，并于咬伤后的第45、60天加注2针狂犬病疫苗。特别是对咬伤头、面、颈部、手指和脚趾及伤口深者，对严重、多处咬伤者，抗狂犬病血清应先在伤口部位进行浸润性注射，余下血清再进行肌肉注射。 Currently Shanghai Municipal treatment principle: in case being bitten by dog, especially the dubious dog, shall inoculate the rabies vaccine immediately and inoculate the vaccine all the month (each on 0, 3, 7, 14, 30 days, totally 5 injections). If the person seriously bitten by the dog on head and face, neck, upper limbs, bosom and back or with several bites on othe