2021 Tianjin Medical and Health Nursing Professional Knowledge: Symptoms and Treatment of Rabies

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Nowadays, people’s lives are relatively stressful, and cats and dogs have become a miracle cure for many people. As long as you come home and see them acting coquettishly at you, you will feel that the fatigue of the day has disappeared. However, they have sharp teeth and claws after all, and when playing with them, there is a risk of being bitten or scratched and infected with rabies virus. You may not take it seriously when you hear this. In fact, rabies is not far away from us. According to data analysis, the incidence of rabies is now all over the world. The number of rabies incidences in my country ranks second in the world, second only to India, and almost all provinces have it. Reported rabies. And once it develops, the mortality rate is almost 100%.

Why is the fatality rate of rabies virus so high?

This is mainly because rabies virus is a neurotropic virus and has a strong affinity for the nervous system. Once infected with rabies virus, it will multiply from the wound in small quantities and invade the peripheral nerves, then continue to invade and multiply along the peripheral nerves, and finally reach the central nervous system and then to various organs of the body. Secondly, rabies virus mainly reproduces in the nervous system and generally does not enter the bloodstream, so when we discover it, it is already in a diseased state. The symptoms are very typical and are mainly divided into three stages. The following is a summary of the clinical manifestations of rabies patients that I will give you. It can be divided into three phases:

(1) Prodromal phase: lasts for 2 to 4 days; symptoms similar to "cold" appear first; then fear and uneasiness appear, and the reaction to sound, light, wind, pain, etc. Sensitivity and a tightness in the throat. There is numbness, itching, pain, and ants walking around after the injury;

(2) Exciting period: lasts for 1 to 3 days; the patient is in a highly excited state, manifested by fear of water (special symptoms), fear of water, etc. Wind, paroxysmal pharyngeal muscle spasm, difficulty breathing, difficulty urinating and defecating, excessive sweating and salivation, etc.;

(3) Paralysis period: lasts for 6 to 18 hours; when the spasm stops, flaccid paralysis may occur. Such as limb paralysis (common), inability to close the mouth, facial stiffness, etc., and eventually death due to respiratory muscle paralysis and bulbar paralysis.

So, what should you do if you are bitten by a dog?

Cleaning the wound immediately and thoroughly is the key to preventing rabies. After flushing, shallow and small wounds should be routinely disinfected with 2% iodine tincture and 75% ethanol solution; deep and large wounds should be fully flushed with 0.1% benzalkonium bromide or 3% hydrogen peroxide solution, and the wound should be left open and drained without suturing or bandaging. At the same time, go to a regular hospital to inject rabies vaccine promptly. For those with deep wounds, local infiltration injections of anti-rabies immune globulin or anti-rabies virus immune serum should be performed at the bottom and around the wound after debridement. If you are scratched by a dog but have no obvious scars, or are licked by a dog, or are suspected of being in close contact with a sick dog, you should also be vaccinated as soon as possible.

At present, we still have no specific medicine for rabies, so prevention is still the main thing for this disease. In the nurse qualification examination, emergency treatment after dog bites is also a common knowledge point. Generally, we will examine everyone in the form of case questions, tell you the background of the patient's dog bite and clinical manifestations at this time, and ask you how to handle the emergency.