So your character is wandering along, minding his own business when out of nowhere a vicious creature leaps on him intent on lunch. The intrepid hero manages to fight the beast off, or perhaps the plucky heroine rescues him for a change, but he’s not without battle wounds. Now what?
What kind of creature was it?
- Small animals like rabbits, rats, and squirrels tend to cause small, painful bites and marks, but unless your character is a hemophiliac, chances are he’ll survive.
- Camels, horses, and other large grazing animals can do some major damage with bites, particularly if they occur on the head or face. Another concern with these animals is crushing injuries from hoofed kicks which can be serious or fatal depending on the force of the blows.
- Domestic cats and dogs come in all shapes and sizes, and their damage capacity varies just as much. The ferocious neighborhood chihuahua isn’t likely to cause nearly the trauma that crazy old Bill’s trio of abused pit bull guard dogs could. Likewise and ancient rolly-polly tabby cat is less likely to eat your face than a muscular tom in his prime.
- Large predator animals, be they tigers, lions or bears (or wolves, coyotes, primates, etc) are the biggest risk. Harder to fight off and with much more advanced weaponry than the average racoon, these big carnivores and omnivores mean business. Their survival depends on their ability to turn the next guy into ground chuck rather than being served up themselves. Big cats in particular come along with an increased risk of infection because they routinely lick their claws, dragging mouth germs all over these 5cm to more than 8cm long weapons.
- Humans (yep, we’re animals too, folks) typically only bite during altercations of some sort (and in undead movies). Our teeth can do a lot of damage to hands and faces, but like the grazing animals above, the damage is usually limited to the cosmetic rather than the life-threatening (vampires and zombies aside). The big risk here is that human bites are much more likely to become infected than most animal bites. Yes, your mouth is dirtier than your dog’s.
First things first – stop the bleeding
In an emergency situation, the ABC’s of triage apply – Airway, Breathing, and Circulation. Most survivable animal attacks are going to endanger the third category, circulation. No blood means no circulation means bye-bye birdie, so the goal of first aid is to keep the blood where it belongs, on the inside. If the blood isn’t gushing out, washing the wound in clean running water is recommended to prevent infection, but stopping the bleeding is more important and more immediate a need.
All but the deepest and deadliest injuries in a normal, healthy person are going to respond to pressure. Obviously if the animal has ripped into the abdominal cavity or neck or sliced through an artery, your character had better hope there’s a rescue chopper on standby. But for flesh wounds, pressure is your friend. To stop most bleeding, apply direct pressure to minor wounds for 5-10 minutes without peeking. Even for deeper gashes, direct pressure will often stop or slow bleeding until further help can be organized.
Minor scratches can be cleaned with soap and water and covered with a clean bandage. Puncture wounds, deep scratches or wounds on the face should be attended to by a medical professional if at all possible. If your character is enjoying the good life in 1810, however, cleaning the wound with clean water and using stitches to close the wound is about the best you can hope for.
Special cases: Facial and scalp wounds
Face and scalp wounds bleed. A lot. Bleeding from scalp or facial wounds, even small cuts, can be pretty significant. Get pressure on it as soon as possible and seal the wound with stitches or surgical-grade bonding liquid (aka medical grade super glue).
Second step – Preventing Bugs
Infection is the most significant risk associated with wounds that are not immediately life-threatening (these include uncontrollable bleeding, penetrating abdominal, head, or chest wounds, neck injuries, head injuries). Keeping wounds clean and covered helps in any setting. In the modern world, small cuts can be covered with a thin layer of antibiotic ointment like Neosporin, Polysporin, or Bacitracin. Large, penetrating wounds may require surgery and/or prophylactic (preventive) antibiotics via either oral or IV methods.
If an infection occurs, symptoms usually start 2-5 days from the initial injury or sometime during the healing process for major wounds (which can take months). Symptoms include redness of the skin around the wounds (see photo, child with infected dog bites to face), increased pain, heat or warmth at the site and on the surrounding skin, foul-smelling drainage or pus (creamy or chunky textured drainage in any of several common colors including yellow, rust-brown, green, pink, blood-tinged, or white), and delayed healing. If the symptoms don’t get any worse, minor wounds usually clear up on their own after a few days or a week in healthy individuals. However, folks who are very old, very young, immune-compromised (prone to getting infected), diabetic, or who have circulation issues, or folks who have deep or large wounds, or whose infections are caused by “super bugs” (antibiotic-resistant germs) can get very sick, very quickly and even die from skin infections.
Signs your character needs a doctor, shaman, or undertaker – fever, chills, generalized feelings of weakness, ill ease, fatigue, red-streaks along the skin starting at the wound and tracing lines outward, irregular heartbeat, or difficulty breathing. These symptoms may indicate a life-threatening spread of infection into the blood stream or other body organs. Some few people recover without aid from this sort of infection, but there is a high risk of death.
Third, consider the source
Bites from your fellow humans typically occur during a fight of some sort. In those situations where there is a likelihood of blood from another person entering an open wound, special tests for HIV and hepatitis are recommended.
Small animals, particularly rodents, can be carriers of Yersinia plague (aka The Black Death, see also Rare Diseases: Yersinia Plague). Yes, even in modern times, Yersinia plague can cause deadly disease, but modern antibiotics can cure the plague if given within a very narrow time frame. Seeking medical attention can be life-saving, particularly in regions where animal carriers of the plague are more common, like the US west.
Wild dogs, stray pets, raccoons, and large predator animals are considered to have rabies unless proven otherwise. Rabies is a disease which, if left untreated, leads invariably to madness and death. Treatment consists of giving a series of vaccine injections after exposure but before symptoms develop. Once symptoms show up, best start digging the grave.
Domestic dogs and cats are considered free of rabies if they have been vaccinated or if they could not possibly have come into contact with wild or unvaccinated animals.
Special Case: Bats in the Attic
Though bats are small mammals not birds, these tiny bug-eaters can harbor rabies virus. Bats are responsible for most of the cases of human rabies that occur in the US. According to the Centers for Disease Control, Rabies can be confirmed only in a laboratory. However, any bat that is active by day, is found in a place where bats are not usually seen (for example, in a room in your home or on the lawn), or is unable to fly, is far more likely than others to be rabid. Such bats are often the most easily approached. Therefore, it is best never to handle any bat. Bats have tiny, needle-sharp teeth that can penetrate the skin and infect a human without even leaving a mark, so if a Sunny Susie awakes to a bat flying around the ceiling, she’d best get the bat tested for rabies, or she could end up looking like this: