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Thu Apr 12 15:06:30 BST 2007

You're being punked.  Huge.

1: You don't test the PATIENT for rabies; you test the ANIMAL (brain tissue
microscopy, last I knew).  By the time either would test positive, they're
goners.
2: You don't DNA test wounds to connect the animal to the patient.  You
quarantine the animal and watch for it to get symptomatic and die.  If it's
alive and behaving like a bear after 10 days, it probably doesn't have
rabies.
3: Human rabies deaths -- which comprise pretty much all but one human
rabies infections in history, I think -- are national news, as are bear
maulings.  There are no lawsuits pending all over the country.  Relax.

If you can't find the offending bear, then vaccinate the patient.  It's that
simple.  And next time you talk to your fish and game guy, look around for
hidden cameras.

Pret Bjorn, RN
Bangor, ME USA

-----Original Message-----
From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org]
On Behalf Of Bryan Karla
Sent: Thursday, April 12, 2007 9:30 AM
To: trauma-list at trauma.org
Subject: Rabid bears

Last night we had a patient come in who had been mauled by a grizzly
bear--no, not the first we've ever had. Today we had a call from a fish
and game conservation officer who asked us if we have a policy for
testing for rabies on these patients (we do not). He also stated that
there are pending lawsuits all over the country on behalf of patients
who have been mauled by rabid bears and died. Families are suing fish
and game and the hospitals because their loved one was not tested for
rabies. He would also like us to swab these patients for possible DNA
testing to help them in identifying the bears when/if they are caught.
My questions: how soon can a patient be tested for rabies and have a
positive test? What type of test is there (other than IgG)? Does anyone
have any kind of policy or protocol for testing these patients that they
would share? If you swab the wounds, to whom do you send the swabs for
analysis? Any other suggestions you can give me would be greatly
appreciated.
Karla Bryan, RN, BSN 
Trauma Services Coordinator 
Eastern Idaho Regional Medical Center 
3100 Channing Way 
Idaho Falls, ID. 83403-2077 
208-227-2027 
Fax: 208-227-2032 
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Karla Bryan, RN, BSN
Trauma Services Coordinator
Eastern Idaho Regional Medical Center
3100 Channing Way
Idaho Falls, ID. 83403-2077
208-227-2027
Fax: 208-227-2032

This e-mail and any files transmitted with it may contain PRIVILEGED or
CONFIDENTIAL information and may be read or used by the intended
recipient.  If you are not the intended recipient of the e-mail or any
of its attachments, please be advised that you have received this e-mail
in error and that any use, dissemination, distribution, forwarding,
printing, or copying of this e-mail or any attached files is strictly
prohibited.  If you have received this e-mail in error, please
immediately purge it and all attachments and notify the sender by reply
e-mail or contact the sender at the number listed.

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Rabid bears