Episode Transcript
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Scot: Halloween's coming up. That means we're going to see an increase of bites no doubt in the ER. Here with Dr. Troy Madsen emergency medicine of the University of Utah Hospital. Do you see more bites like from the werewolves, the vampires and the zombies around Halloween time?
Dr. Troy Madsen: You know, I don't know. I'm working Halloween this year so I'm really curious what I'm going to be seeing that day.
Scot: All joking aside though I thought this would be kind of a fun way to talk about bites.
Dr. Troy Madsen: Yeah.
Scot: You know, so a werewolf could be a dog.
Dr. Troy Madsen: That's probably the best comparison.
Scot: Vampire could be a vampire bat I suppose.
Dr. Troy Madsen: Yeah, yeah. Some sort of bat.
Scot: I don't know what a zombie would be though.
Dr. Troy Madsen: See I'm going to have to compare a zombie to a Komodo dragon just because I imagine the zombie bite is the absolute worst kind of bite you could get.
Scot: Yeah.
Dr. Troy Madsen: So if I were to pick one sort of bite out there that's just a horrible bite to have, just nasty that's just going to do you in and make you one of the walking dead it's a Komodo dragon.
Scot: All right, let's talk about bites for a second. Let's say you get bit by a dog for example.
Dr. Troy Madsen: Yeah.
Scot: What's the major concern that somebody should have immediately after that?
Dr. Troy Madsen: So the immediate concern right afterward is, you know, just the bleeding. Making sure you stop the bleeding, hold pressure on there, make sure there are no issues with that. Once that's under control then the next big question is does it need to be repaired? Is this a laceration that needs to be sewn up and if it's a gaping thing, if you've got a lot of tissue coming out of it, if it's on your face, if there are cosmetic issues, that's something that needs to be sewn up.
One of the big things for me in the emergency department is do we need to worry about rabies? Now if this is a dog, let's say a werewolf in this situation-
Scot: It is a werewolf.
Dr. Troy Madsen: It is a werewolf, that's what we're talking about here. Absolutely with a werewolf you would be concerned about rabies. And since, you know, you may not get bitten by a werewolf the next concern would be a dog where you just don't know anything about the dog. Those are the situations where we get concerned and we give the rabies vaccine. We make sure you have a series of shots. It's I think down to four shots now. I think it used to be a few more and you hear all kinds of horror stories about rabies vaccines. I've heard people say, "Well, you have to get it injected into your stomach," which sounds awful. That's absolutely not the case.
Scot: Not the case?
Dr. Troy Madsen: No, it's not.
Scot: It used to be the case?
Dr. Troy Madsen: I don't know, not since I started practicing.
Scot: All right. That's good news.
Dr. Troy Madsen: But maybe years ago because that sounds miserable. But yeah the rabies vaccine is not that bad but we give it as a precaution because if you get rabies you can't cure it. It's a horrible thing and it'll kill you.
Scot: All right bite number two that you might get around Halloween, blah, vampire.
Dr. Troy Madsen: That's right.
Scot: What happens if a vampire bites you?
Dr. Troy Madsen: So a vampire, you know, vampires are bats so I think the best analogy there is a bat bite.
Scot: Okay. Do you see a lot of bat bites?
Dr. Troy Madsen: We don't. I very rarely will see one and you know kind of the weird situation is we'll actually see cases where a person wakes up in their bedroom and there's a bat in the room. And this is really interesting because the US Centers for Disease Control has said, "If you wake up and there's a bat in your room you need to assume you've been bitten."
Scot: They made a statement on this.
Dr. Troy Madsen: They have made a statement.
Scot: Okay.
Dr. Troy Madsen: And it's in their guidelines that you need to have the rabies vaccine. Again, it's getting back to that whole rabies thing and that's our big concern with bat bites.
Scot: The last bite you might get around Halloween time, zombie.
Dr. Troy Madsen: Yeah.
Scot: Be turned into the undead. And you compare that to a Komodo dragon.
Dr. Troy Madsen: Yeah, yeah. Komodo dragons. Obviously we don't see a lot of Komodo dragon bites.
Scot: Sure.
Dr. Troy Madsen: But if I had to draw the best comparison I could to a zombie bite I would say a Komodo dragon.
Scot: And why's that? Yeah.
Dr. Troy Madsen: Because it's just the worst bite you can get. It's amazing how much bacteria Komodo dragons have in their mouths. These locations where they actually have wild Komodo dragons there are reports- I mean that's how they kill animals with just the amount of bacteria in their mouth. I mean there's the force of their bite but they're mouths aren't really that big, but they bite these animals and these animals have severe sepsis, like severe bacterial infections and will often die within hours.
So if we were to ever get someone say from the zoo, if you had like a zoo handler that came in after a bite, man, I would give him every antibiotic I could. I'd have him IV antibiotics, admitted to the hospital, because these things are awful.
So Halloween's coming up. Be safe. Watch out for those werewolves, vampires and zombies. And if you do happen to get bitten, I'll be waiting for you in the ER.
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