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General recommendations in case of an attack or encounter include attempting to
remove the perceived threat to the animal, i.e., you. In an unanticipated encounter, slowly
and quietly back away. Running away will often elicit a predatory response. "Playing
dead" by dropping to the ground, rolling into a knee-to-chest ball and covering your head
and face with your arms is advised in a sudden grizzly encounter. These maneuvers all
"remove the threat."
If an attack is unprovoked, with human seen as prey, aggressively fighting back is
recommended. Behavior such as advancing rather than fleeing, making loud noises, or
waving arms to appear larger and more threatening may forestall an attack. Vigorous
resistance with physical fighting, including striking the attacking animal with fists or any
object or weapon, has been effective in repelling attacks by cougars, lions, tigers, brown
and black bears, and even crocodiles. Cayenne pepper spray may be useful if approached
by a bear. Many people carry firearms in "bear country." Both pepper spray and firearms
may provide a false sense of security. Both must be use correctly by persons trained in
their use to be effective.
Avoidance is best. Common sense dictates care in traveling, camping, food
storage, cooking and sleeping. Preparation with a plan of action in case of an attack is
strongly advised.
III. GUIDELINES FOR ASSESSMENT AND TREATMENT
Scene safety is an initial consideration for rescuers: Is the animal gone or liable to attack
again? Do not spend time tracking the attacking animal unless adequate assistance to the
victim is simultaneously available and rescuers are experienced and competent in such
activity.
Attend to ABC's as always. Airway management may be complicated with head,
facial, neck or chest injuries. Assume all victims of large wild animal attacks have
sustained multiple traumas. Beyond the obvious bite, claw or goring wounds, the victim
needs assessment for fractures, neurovascular damage, and internal head, chest and
abdominal injury. Try to determine the mechanisms of injury. Soft tissue damage far
beyond the obvious may result from trampling, butting or tossing with ground impact.
Bites regularly penetrate more deeply than apparent. Recognize the factor of
psychological trauma, even in the field.
Wound cleaning is the single most important step in preventing infection: its
importance cannot be overemphasized (see Wilderness Wound Management). Splint
large open wounds and fractures (see Orthopedic Injuries). Cover abdominal
eviscerations and eye injuries with a moist, clean dressing--and evacuate rapidly.
Vigorously irrigate animal bites with water safe to drink, then scrub with soap and
water, followed by a 60- to 90-second rinse with a 1% concentration of povidone-iodine
or 0.5% chlorhexidine gluconate, if available. Except where necessary to control
hemorrhage or to allow extrication, never close or tightly approximate an animal bite
wound in the wilderness. Devitalized, necrotic tissue from bite and crush injuries requires
debridement. Many of these injuries are contaminated; the decision to close wounds after
thorough irrigation and debridement should consider the risk of the patient (higher risk
for immune compromised patients) and of the wound (higher risk if deep punctures,
contaminated with oral flora, in the hand or poorly vascularized tissues.) High risk
wound and/or high risk patients should receive prophylactic antibiotics such as
