Rabies and Practicing Medicine in Bush Alaska—Some ABCs: Difference between pages

From Guide to YKHC Medical Practices

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With a preponderance of dogs on the Delta, you may be faced with many bites. The important issues concern the fear of rabies and the risk of infection.
See [[:Category:YKHC Guidelines|YKHC Clinical Guidelines]] for recommendations on treatment and management of many of these diagnoses through our system.
Any unprovoked attack, or an attack by an unknown animal or unimmunized animal, should be considered for treatment for rabies. All bites should be reported to OEH. (543-6420)


There are “Rabies Investigation Report Forms” that should be filled out – (all the health aides and ER have) and there is always an OEH person on call if you have questions. (The operator keeps the list.) If the bite is severe it may need to come to Bethel. The rabies vaccine series may need to be given. The animal often needs to be caught and the brain sent for studies. The animal is usually quarantined for 10 days for observation before the decision to send the brain for rabies is made.
{|class="wikitable" style="width: 100%; margin: auto:"
* Local care of any dog bite includes washing with soap and water.
! style="text-align:center;"|CARDIOVASCULAR
* Fox bites are especially rabies prone.
! style="text-align:center;"|INFECTIOUS DISEASE
* The patient should receive a tetanus shot if they haven’t had one within 5 years.
! style="text-align:center;"|NEONATAL
* High-risk
! style="text-align:center;"|PREVENTATIVE HEALTH CARE
* Bulleted list item
|- style="vertical-align:top;"
*wounds probably require prophylaxis, but this is controversial. Oral flora usually complicate the wound and treatment should be considered for:
|
**any wound showing signs of infection
* [[Myocardial Infarction – Acute|Acute Coronary Syndrome (Myocardial Infarction)]]
**any wound that is difficult to clean
* [[Atrial Fibrillation / Atrial Flutter]]
**any wound in a critical area (face, hand, etc.).
* [[Congestive Heart Failure]]
*Organisms usually include
* [[Hypertension]]
**Streptococci
|rowspan="5"|
**Eikenella Corrodens*
* [[Amoxicillin Allergy Trials]]
**S. Aureus
* [[Botulism]]
**Bacteroids
* [[Chronic Cough/Bronchiectasis – Pediatrics|Bronchiectasis/Chronic Cough]]
**Peptococcus
* [[Bronchiolitis / Wheezing – 3-24 Months|Bronchiolitis/Wheezing]]
**Petostreptococci
* [[Croup/Stridor: Evaluation & Treatment|Croup/Stridor]]
**Pasteurella (14-50% dogs, 50-75% cats)
* [[Fever – Infants 0-90 days|Fever (0-90 days)]]
Penicillin resistant gram-negative rods are infrequent pathogens. *Eikenella is unusual in that it is often sensitive to PCN and Ampicillin, but not to oxacillin/methecillin/nafcillin/clindamicin.
* [[Fish Finger]]
 
*[[Haemophilus influenza type a (Hia)]]
Amoxicillin/clavulanate would be the best choice for prophylaxis if it were needed.
* [[Influenza]]
 
* [[Acute Cervical Lymphadenitis Evaluation & Treatment – Pediatrics|Lymphadenitis, Acute Cervical]]
===Resources/References===
* [[Otitis Media 3 months–12 years|Otitis Media, Acute]]
*[[media:Rabies.pdf|Rabies YKHC Clinical Guideline]]
* [[Peritonsillar Abscess]]
 
* [[Pharyngitis|Pharyngitis (Group a Strep)]]
[[:category:YKHC Guidelines]]
* [[Pneumonia – Adult|Pneumonia (Adult)]]
<br/>[[Practicing Medicine in Bush Alaska—Some ABCs|Common/Unique Medical Diagnoses]]
* [[Pneumonia – Pediatric More Than 3 Months|Pneumonia (Pediatric)]]
* [[ANMC ADULT Procalcitonin (PCT) Utilization Guideline/Clinical Pathway|Procalcitonin (Adult)]]
* [[Rabies]]
* [[Sepsis – Adult|Sepsis (Adult)]]
* [[Sepsis – Pediatric|Sepsis (Pediatric)]]
*[[Septic Joint]]
* [[Sexually Transmitted Infections]]
* [[Sinusitis More Than 5 Years|Sinusitis]]
* [[Skin and Soft Tissue Infection|Skin and Soft Tissue Infection (Abscess/Cellulitis)]]
* [[Tuberculosis (Active and LTBI)]]
* [[UTI – Adult]]
* [[UTI – Children 3 Months–5 Years]]
* [[Varicella]]
|
*[[Newborn GBS & Infection Evaluation and Treatment|Newborn Early-Onset Sepsis/GBS]]
*[[Jaundice – Neonatal Evaluation & Treatment|Neonatal Jaundice]]
*[[Neonatal Glucose Screening Evaluation and Treatment|Neonatal Glucose Screening]]
|
* [[Amoxicillin Allergy Trials]]
* [[Breast Cancer Screening]]
* [[Lead Evaluation – Pediatrics|Lead Level, Blood (Pediatric)]]
|-
! style="text-align:center;"|GASTROINTESTINAL
! style="text-align:center;"|NEUROLOGY
! style="text-align:center;"|PSYCHIATRY
|- style="vertical-align:top;"
|
* [[Helicobacter pylori in Alaska Natives|Dyspepsia – H. Pylori]]
* [[Hepatitis B]]
* [[Hepatitis C]]
|
* [[Head Injury / Concussion  Under 18 Years]]
* [[Ischemic Stroke – Acute| Ischemic Stroke, Acute]]
* [[Pediatric Seizures|Seizures (Pediatric)]]
|
* [[Alcohol Hangover/Withdrawal]]
* [[Attention Deficit Hyperactivity Disorder in Children|Attention Deficit Hyperactivity Disorder in Children (ADHD)]]
*[[Fetal Alcohol Syndrome (FASD)]]
* [[Title 47 Hold]]
|-
! style="text-align:center;"|GENETICS/ENDOCRINE
! style="text-align:center;"|OBSTETRICS
! style="text-align:center;"|TRAUMA/INJURY/INGESTION
|- style="vertical-align:top;"
|
*[[Congenital Adrenal Hyperplasia (CAH)]]
*[[Congenital Sucrase-Isomaltase Deficiency (CSID)]]
*[[CPT1A Arctic Variant]]
* [[Type 2 Diabetes|Diabetes (Type 2)]]
* [[HLA-B27]]
*[[Kuskokwim Syndrome (Arthrogryposis-like syndrome)]]
*[[Metachromatic Leukodystrophy (MLD)]]
*[[Micro-aspiration (in Apparently Neurologically Typical Children)]]
* [[Osteoporosis]]
*[[Rickets and Vitamin D Deficiency]]
*[[Septo Optic Dysplasia]]
|
* [[Anemia in Pregnancy]]
* [[Anti-D Immune Globulin]]
* [[Chronic Hypertension in Pregnancy]]
* [[Ectopic Pregnancy – Treatment|Ectopic Pregnancy]]
* [[First Trimester Vaginal Bleeding: Ectopic Pregnancy Diagnosis & Treatment of Non-Viable Early Pregnancy|First Trimester Vaginal Bleeding]]
* [[Gestational Diabetes]]
* [[Gestational Hypertension]]
* [[Group B Streptococcus (GBS) – Maternal]]
* [[Intrahepatic Cholestatis of Pregnancy (IHCP)]]
* [[Intrauterine Growth Restriction (IUGR)]]
* [[Molar Pregnancy]]
* [[Oligohydramnios]]
* [[Postpartum Hemorrhage]]
* [[Preterm Labor – Screening and Prevention|Preterm Labor]]
* [[Preterm Premature Rupture of Membranes]]
* [[Vaginal Birth After Cesarian]]
|
* [[Acetaminophen Overdose]]
* [[Burn Evaluation and Treatment]]
* [[Frostbite]]
|}

Revision as of 22:42, 16 August 2021

See YKHC Clinical Guidelines for recommendations on treatment and management of many of these diagnoses through our system.

CARDIOVASCULAR INFECTIOUS DISEASE NEONATAL PREVENTATIVE HEALTH CARE
GASTROINTESTINAL NEUROLOGY PSYCHIATRY
GENETICS/ENDOCRINE OBSTETRICS TRAUMA/INJURY/INGESTION
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