SOPs for management of DOG BITE

Management of dog bites is 4 fold

 Wound management
 Rabies prophylaxis
 Tetanus prophylaxis
 Pain management
Wound management:

 Wash the wound with normal saline

 Clean the wound with pyodine
 Don’t stitch the wound except it is widely open
 In case of wide gap wound apply 2 or 3 loose stitches and let the fluid or pis drain from the
wound
Rabies prophylaxis:
 It patient presents within 24 hours of dog bite then ask whether god was domestic or stray
dog.
 In case of domestic dog bite give 1st and 2nd dose of anti rabies vaccine and follow the
patient for 10 days. If he remains symptom free then vaccination can be stopped further
 In case of stray dog completes the vaccination schedule of 0,3,7,14,28 and 90 days anti
rabies vaccine
 In case of rabid god anti rabies serum is given with dose of 20U/kg.
Tetanus prophylaxis:
 Tetanus prophylaxis should given In case of deep wounds.
Pain management:
 In case of pain oral pain killer can be given
 In case of sever pain i.v or i.m killer may be given.
Clinical SOPs for Management of Cardiac Arrest
01. Asses of patient.
 Respiration
 Vitals
02. Call for Help.
03. Start CPR
04. Maintain Airway , Breathing ,
Circulation
05. Save I/V lines.
06. Get defibrillate as soon as possible
and identify the ECG rythm and
defibrillate if necessary.
07. Identify the causes of arrest.
08. Inform Consultant on Call
09. Inotropic support if necessary.
10. After initial resuscitation if patient
revive then refer to tertiary care hospital
For ICU care
 SOPs FOR TREATMENT OF ANAPHYLACTIC REACON

1. Inform doctor on duty.

2. Discontinue drug administration.
3. Administer 100% oxygen.
4. Check vitals.
5. Maintain Airway, Breathing, Circulation.
6. Save peripheral I/V line.
7. Inj. Epinephrine(0.01-0.5mg, I/V or I/M).
8. I/V fluid bolus.
9. Hydro cortisone (up to 200 mg I/V).
10. Diphenhydramine 50-70mg I/V.
11. Ranitidine 150mg I/V.
12. Inform/Consultant Physician.
13. If patient shell vitally stable or airway/ breathing
compromised then refer to tertiary care hospital.
SOPs FOR MANAGEMENT OF PATIENT MI

1. Identify the wearing signs.

a) Chest pain/discomfort
b) Pain in upper body such as neck/jaw/upper back/arms.
c) A squeezing feeling or tightness in chest.
d) Difficulty in breathing.
e) Sweating.
f) Nauseal vomiting.
g) Dizziness.
2. Cell for help.
3. Save I/v line.
4. Check vitals.
5. Supplemental oxygen if SPO2 less then 90%
6. Take a 12 lead ECG.
7. S/L nitrates.
8. Administration of asprine.
9. Refer to tertiary care hospital/ccu for further
Management.