title: Law enforcement K-9 dog bites: injuries, complications, and trends.
abstract: OBJECTIVE
  To quantify the number of individuals bitten, the number of bites per patient, and the types of injuries and complications caused by law enforcement K-9 dog bites treated in the Jail Ward Emergency Department of the Los Angeles County-University of Southern California Medical Center. These variables were compared before and after a change in K-9 police policy from the "bite-and-hold" to the "find-and-bark" technique or stricter controls were instituted over the K-9 teams.
  
  
  METHODS
  A retrospective chart review of all patients in police custody with K-9 dog bites who presented to the Jail Ward ED between January 1, 1988, and December 31, 1995, was conducted. Demographic data of patients with K-9 dog bites, the number and location of bites, complications, procedures performed, and management of bites were recorded and compared between the periods 1988-1991 (before the policy changes) and 1992-1995 (after the changes).
  
  
  RESULTS
  Between 1988 and 1995 790 in-custody patients were treated for K-9 dog bites in the Jail Ward ED; 705 charts were available for review. Nearly all the patients (98.6%) were male, with a mean age of 25; 85.0% were Hispanic or black. More than half (57.2%) sustained three or more bites, mainly to the extremities. Complications ensued in 19.3%: vascular in 7.0%, infection in 5.0%, fracture or cortical violation in 4.0%, nerve injury in 1.9%, and tendon injury in 1.1%. Half (49.9%) were hospitalized, with a median stay of 3 days. After the change in K-9 policy, the number of patients with K-9 dogs bites presenting to the Jail Ward ED decreased from 639 (1988-1991) to 66 (1992-1995). The proportion of patients who sustained three or more bites decreased from 58.4% to 45.5%. The rate of vascular complications decreased from 7.5% to 1.6%, the rate of fractures decreased from 2.4% to 0, and the rate of cortical violations increased from 1.4% to 6.3%. The proportion of patients hospitalized decreased from 52.0% to 33.8%.
  
  
  CONCLUSIONS
  K-9 dog bites are associated with significant injuries and complications. In this study, changes in law enforcement K-9 policy contributed to a significant decrease in the overall number of individuals bitten, the number of injuries and complications, and the proportion of patients hospitalized.
authors.affiliation: Department of Emergency Medicine, Brigham and Women's Hospital, Harvard Medical School Boston, Massachusetts, USA.
authors.forename: H R
authors.initials: HR
authors.lastname: Hutson
authors.forename: D
authors.initials: D
authors.lastname: Anglin
authors.forename: G V
authors.initials: GV
authors.lastname: Pineda
authors.forename: C J
authors.initials: CJ
authors.lastname: Flynn
authors.forename: M A
authors.initials: MA
authors.lastname: Russell
authors.forename: J J
authors.initials: JJ
authors.lastname: McKeith
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D001733:Bites and Stings / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D004285:Dogs; D004632:Emergency Medical Services; D005260:Female; D006760:Hospitalization / Q000639:trends; D006801:Humans; D015141:Los Angeles / Q000453:epidemiology; D008297:Male; D016134:Organizational Policy; D016495:Police / Q000458:organization & administration; D011159:Population Surveillance; D011330:Prisons; D012189:Retrospective Studies