A pull-out poster version of Rozelle campus paramedic practice lecturer Janelle White's B.I.T.E.S tool is popping up in surgeries around Australia after being published in Australian Doctor, a journal which is circulated to more than 20,000 GPs.
The impetus for the assessment tool was an emergency call that Mrs White, who is an extended-care paramedic, responded to. The four-year-old's mother had called triple-O after having difficulty waking her daughter.
"She was seriously ill from sepsis (blood poisoning). On the way to the hospital I noticed that the girl had a puffy hand. When I pointed this out her mother recalled that her daughter had come to her four days earlier, in tears, after being bitten by a kitten while playing at a friend's place. There had been just a tiny pinprick of blood on her arm.
"If her mother had known that there was a more than 80 per cent chance of infection with a cat bite, then she was would have gone to a doctor, who would have prescribed prophylactic antibiotics. But she didn't know that and her daughter nearly died."
Mrs White said that spider, snake and marine bites were a common educational focus in paramedic practice. "But no one talks about mammalian bites. So I chose four: dog, cat, human and bat bites – two common, two high-risk, potentially fatal – and came up with five essential checkpoints (B.I.T.E.S – bite features; infections/injections; treatment/time; existing health considerations and symptoms and signs)."
After presenting at an international zoonoses conference last year, she was approached by the Greencross Vets chain, seeking permission to display copies of her poster in their surgeries dotted around Queensland, NSW, Victoria and South Australia.
"From there it snowballed," she recalls, "particularly after an eight-year-old Cairns boy died in February from Australian bat lyssavirus."
Her assessment tool is now being assessed by the Victorian Department of Health for use on its Better Health Channel website and the Queensland and Northern Territory health departments for use in hospital emergency departments. The SA Health Department will soon began distributing copies of the tool to local health networks and Medicare locals in that state.