A comparison of dog bite injuries in younger and older children treated in a pediatric emergency department

Objective: Dog bites account for a significant number of traumatic injuries in the pediatric population that often require medical treatment. Although agent, host, and environmental characteristics of dog bites have been well documented, no attempt has been made to compare these characteristics by patient age group. The purpose of this study is to determine if differences exist in agent, host, and environmental characteristics among younger (less than or equal to6 y) and older (>7 y) patients treated in a pediatric emergency department (ED) for dog bites. Findings from our study could be used to develop age-specific strategies for dog bite prevention. Theoretical Framework: The epidemiologic triad of agent/host/environment formed the theoretical framework. Methods: The study setting was the ED at Children's Hospital of Pittsburgh. Patients were enrolled between 1999 and 2000 and were identified through a review of ED records (n = 386) of children sustaining dog bites. Records were abstracted with a researcher-designed and validated form for agent (eg, breed, number of biting dogs, owner, rabies status), host (eg, age, gender, number and location of bites, treatment), and environmental (eg, bite month and time, bite location, events leading to the bite, ZIP code) characteristics. Data were analyzed using descriptive and inferential statistical tests. Results: Children younger than 6 years constituted 52.8% (n = 204) of the sample. As compared with older children, a higher proportion of younger children were bitten by their family dog (chi(2) = 27.64, P = 0.001) whose rabies shots were up to date (chi(2) = 12.08, P = 0.034). A higher proportion of younger children were bitten on the face (chi(2) = 49.54, P = 0.000) and were bitten in their own homes (chi(2) = 16.075, P = 0.013). Implications for Nursing Practice: Young children frequently sustain dog bites from their family dog in their own homes. Injuries typically involve severe lacerations to the face. Prevention strategies for young children include close supervision of child-dog interactions.