Environmental Exposures 473442.A 26-year-old man presents to the ED in agony with a Gila monster
still attached to his arm after being bitten. He reports that he is the animal’s
main handler, with no prior biting incidents. He reports localized pain but
denies weakness, nausea, or feeling lightheaded. The animal bite occurred
about 45 minutes ago. After the animal is carefully removed, what should be
done next in the care of this patient?
a. Check for any remaining embedded teeth and begin wound care.
b. Administer antivenin.
c. Give tetanus prophylaxis.
d. Administer broad-spectrum antibiotics.
e. Apply suction device.
443.An anxious college student presents to the ED at 2 AMstating a bat woke
him up. He heard something flying around his bedroom and when he turned
the lights on, he saw a bat fly into his closet. He is unsure if he was bit by the
bat but noticed bat droppings in his bed. Which is the most appropriate man-
agementfor the patient?
a. Reassure him that there is nothing to do and discharge him.
b. Immunoprophylax with human rabies immune globulin and human diploid cell
vaccine.
c. Administer ciprofloxacin 500 mg.
d. Admit him to the hospital for 24 hours of observation.
e. Immunoprophylax with human diploid cell vaccine.