Patrick, a five-year-old boy, had been quietly playing in his family's backyard for about an hour. Every time his mother looked out the window to be sure he was OK, he was busily building roads and caves in his sandbox or imagining exciting adventures with plastic people. It only took her a few minutes to put away the day's laundry upstairs before her next check on Patrick. She never heard her son approach the strange dog, nor did she hear his first screams. By the time she returned to her vantage point, she saw that a dog had her son trapped against a fence with no room for escape and no way to protect himself. Already bitten, his hand was bleeding and his face was filled with fear. When paramedics arrived, they had to deal with an injured child, a frantic parent and a vicious dog.

   Dogs are ubiquitous in our society. Numbering over 50 million, they often share not only our workspaces, but our homes as well.¹ This relationship is usually one that fosters positive emotions and increased mobility and safety for pet owners. However, there are times when human-canine interactions result in less desired outcomes in the form of bites, other injuries and even deaths (see Table 1). During 2007, more than 300,000 dog bite injuries were seen in emergency rooms (an injury rate of 103 per 100,000).² When these occur, it is possible that EMS providers will be called to a scene where they will come face to face with an aggressive dog. This article will discuss aggressive dogs, their behavior and some strategies for dealing with them.

BREEDS AND BITES

   It is not known with certainty how many dogs of each breed exist in the country, so calculating "bite rates" is difficult. The best data available indicates that the breed most likely to kill someone is the pit bull terrier. Other dogs, like the Rottweiler, German shepherd and others, have been known to kill as well. These breeds may be genetically predisposed to be violent, but this predisposition is surely affected by training and health. It is worth noting that some breeds are more popular than others meaning there are more of them to potentially bite someone. The popularity of breeds waxes and wanes over time, and it is probable that the types of dogs that bite most often may change to reflect that flux in popularity (see Table 2).³

WHO IS MOST LIKELY TO BE BITTEN?