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2.
Ann Emerg Med ; 29(5): 637-42, 1997 May.
Artigo em Inglês | MEDLINE | ID: mdl-9140249

RESUMO

STUDY OBJECTIVE: To quantify the number of individuals bitten, the number of bites per patient, and the types of injuries and complications caused by law enforcement K-9 dog bites treated in the Jail Ward Emergency Department of the Los Angeles County-University of Southern California Medical Center. These variables were compared before and after a change in K-9 police policy from the "bite-and-hold" to the "find-and-bark" technique or stricter controls were instituted over the K-9 teams. METHODS: A retrospective chart review of all patients in police custody with K-9 dog bites who presented to the Jail Ward ED between January 1, 1988, and December 31, 1995, was conducted. Demographic data of patients with K-9 dog bites, the number and location of bites, complications, procedures performed, and management of bites were recorded and compared between the periods 1988-1991 (before the policy changes) and 1992-1995 (after the changes). RESULTS: Between 1988 and 1995 790 in-custody patients were treated for K-9 dog bites in the Jail Ward ED; 705 charts were available for review. Nearly all the patients (98.6%) were male, with a mean age of 25; 85.0% were Hispanic or black. More than half (57.2%) sustained three or more bites, mainly to the extremities. Complications ensued in 19.3%: vascular in 7.0%, infection in 5.0%, fracture or cortical violation in 4.0%, nerve injury in 1.9%, and tendon injury in 1.1%. Half (49.9%) were hospitalized, with a median stay of 3 days. After the change in K-9 policy, the number of patients with K-9 dogs bites presenting to the Jail Ward ED decreased from 639 (1988-1991) to 66 (1992-1995). The proportion of patients who sustained three or more bites decreased from 58.4% to 45.5%. The rate of vascular complications decreased from 7.5% to 1.6%, the rate of fractures decreased from 2.4% to 0, and the rate of cortical violations increased from 1.4% to 6.3%. The proportion of patients hospitalized decreased from 52.0% to 33.8%. CONCLUSION: K-9 dog bites are associated with significant injuries and complications. In this study, changes in law enforcement K-9 policy contributed to a significant decrease in the overall number of individuals bitten, the number of injuries and complications, and the proportion of patients hospitalized.


Assuntos
Mordeduras e Picadas/etiologia , Cães , Polícia , Adolescente , Adulto , Animais , Mordeduras e Picadas/epidemiologia , Mordeduras e Picadas/terapia , Serviços Médicos de Emergência , Feminino , Hospitalização/tendências , Humanos , Los Angeles/epidemiologia , Masculino , Política Organizacional , Polícia/organização & administração , Vigilância da População , Prisões , Estudos Retrospectivos
3.
Acad Emerg Med ; 3(4): 352-9, 1996 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-8881545

RESUMO

OBJECTIVE: To review the types of injuries due to law enforcement (K-9) dog bites and address related management issues. METHODS: A case series of law enforcement dog bite victims is reported and related literature reviewed. RESULTS: Law enforcement dogs are taught a bite-and-hold technique for subduing individuals suspected of felony crimes. This bite-and-hold technique's greater applied force results in a unique spectrum of injuries, including deep puncture wounds, severe crush injuries, large tissue avulsions and lacerations, wounds necessitating surgical débridement, bony injuries ranging from cortical violations to displaced fractures, neurovascular damage, and other wounds at high risk for infection. The four reported cases highlight the types of injuries and complications associated with law enforcement dog bites. CONCLUSION: Attention to potential deep injuries of nerves, vessels, and the musculoskeletal system is essential with law enforcement dog bites. Injuries associated both with pursuit and arrest and with the bites themselves must be identified and assessed. Guidelines for the ED treatment of patients with law enforcement dog bite injuries are proposed.


Assuntos
Mordeduras e Picadas/terapia , Cães , Serviço Hospitalar de Emergência , Polícia , Adolescente , Adulto , Animais , Mordeduras e Picadas/diagnóstico , Mordeduras e Picadas/fisiopatologia , Terapia Combinada , Humanos , Masculino , Guias de Prática Clínica como Assunto , Resultado do Tratamento , Ferimentos e Lesões/diagnóstico , Ferimentos e Lesões/fisiopatologia , Ferimentos e Lesões/terapia
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