Beware of Dog Bites: Tips to Prevent a Medical Emergency

Dogs can be friendly and loyal companions, but they are still animals that can bite.

Each year in the United States there are 4.5 million dog bites, and 800,000 of them require medical attention.

Nearly half of dog bites occur in children between the ages of 5 and 9.

In 2023, Kapiolani Medical Center for Women & Children treated 17 dog bite cases, up from eight cases the previous year.

"We've been treating a marked increase in severe dog bite cases here at Kapiolani," said Alissa Lo, trauma program manager for Kapiolani. "The number of dog bites requiring surgical repair has more than doubled between 2022 and 2023."

Kapiolani Medical Center serves as Hawaii's only Pediatric Trauma Center designated by the Hawaii Department of Health. Its pediatric trauma program team provides quality care for children in Hawaii and the Pacific region who sustain injuries from incidents such as falls, burns, motor vehicle collisions, sports injuries and more, including dog bites.

According to Lo, children between the ages of 1 and 6 years were bitten the most, and more males were bitten than females. The face was the most common place of injury to the body; hands were the next common.

Many of these injury cases needed surgical intervention.

Preventing Dog Bites

According to the American Academy of Pediatrics, one in five people bitten by dogs require medical attention. For children, the injuries are more likely to be serious since the majority of injuries occur to the head, face or neck.

Prevention starts with adult supervision when kids are around dogs, and other animals.

Parents should be aware of some simple steps that can prevent dog bites:

Never Leave a Child and a Dog Alone Together

• This includes the family dog, a dog that is known to you or a dog that you have been assured is well behaved. Any dog can bite.
• Lo notes that many cases seen at Kapiolani involve children being around unleashed pets and family dogs. In fact, several cases reported in 2023 happened when a child attempted to pet their family's dog and the dog turned on the child.

Ask Permission Before Petting a Dog

• Teach children to ask a dog owner for permission before petting any dog.
• Then, "ask" the dog for permission by letting it sniff you or your child before petting the dog.

Be Gentle and Respectful with the Dog

• Move calmly and slowly around dogs.
• Avoid petting the face or tail. Pet the dog gently, and avoid eye contact, particularly when you first begin petting the dog.
• Never bother a dog that is sleeping, eating or caring for puppies. Dogs in these situations are more likely to respond aggressively, even with a person who is familiar to them.
• Do not allow your child to play aggressive games with a dog, such as tug-of-war or wrestling, as this can lead to bites.

"When I was 7 years old, I was playing outside with a hula hoop and our dog, King, a purebred German Shepard. Instead of jumping through the hula hoop, he jumped up at me and bit my top lip," recalls Lisa Dau, a registered nurse and injury prevention coordinator at Kapiolani. "I was fortunate that when my mom took me to the ED, a plastic surgeon was on staff that day and stitched me up. To this day, I fear dogs, hate hula hoops, and I will never forget that incident."

What to Do in an Emergency

Even if you follow all of the steps above, dogs can respond unpredictably.

Teach your child that if a dog is behaving in a threatening manner – for example, growling and barking – they should remain calm, avoid eye contact with the dog, and back away slowly until the dog loses interest and leaves.

If you or your child is knocked over by a dog, curl up into a ball and protect your eyes and face with your arms and fists.

If a dog bites your child, follow these steps:

• If your child is severely bitten, call 911 or bring your child to an emergency department for treatment.
• Be prepared to tell the ED doctor about your child's tetanus vaccination status, the dog's vaccine status (or offer contact information for the dog's veterinarian), the dog's owner and if you know that the dog has bitten a person before.
• Follow your pediatrician's instructions to ensure proper healing of all wounds.

Published on: April 17, 2024