Bite Wound History
Bite Wound Onset [text] prior to evaluation Onset while: [text] Injury at [text] Source of bite: [text] Provoked by: [text] Animal appearance: [text] Animal immunization status: [text] Animal is now at [text] and can [text] be observed for 10 days Prior to injury, wound site covered with (e.g. clothing) [text] After the injury, prior to arrival, wound was cleaned with [text] Pitfall evaluation: [select value="no|YES"] <-- suspected foreign body [select value="no|YES"] <-- wound contamination [select value="no|YES"] <-- distal numbness [select value="no|YES"] <-- distal weakness [select value="no|YES"] <-- distal cold sensation, pallor, or cyanosis [select value="no|YES"] <-- continuous bleeding despite applied pressure [select value="no|YES"] <-- fever [select value="no|YES"] <-- wound discharge [select value="no|YES"] <-- local redness Pertinent PMH: Last Tetanus vaccine: [text] [select value="no|YES"] <-- Diabetes Mellitus [select value="no|YES"] <-- Peripheral Vascular disease [checkbox memo="display/hide references" name="footnotes" value=""][conditional field="footnotes" condition="(footnotes).is('')"] reference: contributed by Dr. Scott Moses, creator/author of the Family Practice Notebook [link url="http://www.fpnotebook.com" memo="website"][/conditional]
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