[Medical Q&A] What does “first flush, second disinfect, third treat” mean after being scratched or bitten by a cat or dog?

Planner: Chinese Medical Association

Reviewer: Huang Lei, deputy chief physician, Fifth Medical Center, PLA General Hospital

It is very dangerous for people to be bitten, scratched or licked by cats and dogs carrying rabies virus. This condition is called "rabies exposure" in medicine. It is very important to treat the wound promptly and correctly after exposure, which is even more important than vaccination! The general principle of self-emergency treatment is: "first flush, second disinfection, third treatment".

(1) “One flush”: Wound flushing. Immediately flush each bite or scratch wound with soapy water (or other weak alkaline cleaning agents) and running clean water at a certain pressure for at least 15 minutes; flush and squeeze to remove the animal’s saliva as much as possible and drain the dirty blood carrying the virus to reduce the chance of bacteria entering the wound.

Note: Never suck the wound with your mouth to prevent the virus from infecting the oral mucosa.

(2) "Second disinfection": Wound disinfection. After thoroughly rinsing the wound, use 2% to 3% iodine tincture, benzalkonium bromide or other skin and mucous membrane disinfectants with virus inactivation effect to disinfect the wound to kill any bacteria that may be present.

Note: When using disinfectant, be careful not to apply too much force to avoid irritating the wound.

(3) "Three treatments": surgical treatment. Use sterile gauze or bandages to cover the wound to avoid external contamination. If the dressing becomes wet or dirty, it should be replaced in time.

Note: After the above emergency treatment, you should go to the hospital to get rabies vaccine as soon as possible. However, not all hospitals have rabies vaccine in stock. Generally, you can go to the Center for Disease Control and Prevention or the medical institution designated by the health administration to get rabies vaccine. If the wound is deep or there are pollutants such as dirt and dust, you should also get tetanus vaccine or antitoxin.