A Challenge Getting Medical Care in Rural PA
The City of Pittsburgh is abound with hospitals and urgent care facilities to treat injuries caused by canines. However, residents of rural Pennsylvania fare less well. For example, victims living in Beaver, Butler, Washington, Greene, Westmoreland and Mercer Counties often face a “medical desert” from limited access to emergency and specialized care after a dog bite.
A Nationwide Medical “Desert”
This problem exists nationwide: many rural areas across the U.S. are identified as “medically underserved.” An estimated thirty million adult Americans live at least a sixty-minute drive from a hospital with trauma care services. Many also find they have fewer primary care providers —factors that delay timely treatment for bite victims.
The same goes for kids. A study analyzing over 1,000 dog bite cases across Pennsylvania found that rural child patients experienced more delays in care compared to their urban counterparts. Those in rural areas were also more likely to require inter-hospital transfers, especially when surgical specialists were needed.
This reflects a broader health equity issue: rural patients must often endure lengthy journeys, miss work, or face high transportation costs to obtain necessary wound care, rabies prophylaxis, or reconstructive treatment—resources more readily available in urban centers like Pittsburgh.
How Bad is it in Less-Populated Areas of PA?
In truth, much of rural Western Pennsylvania suffers from a rural health professional shortage:
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In Pennsylvania, 26% of rural residents live in Health Professional Shortage Areas (HPSAs), compared to only 2% of urban residents.
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Overall, only about 32.8% of mental health care needs (e.g., emotional distress from an attack) are met in Pennsylvania’s designated shortage regions.
But why is this so? The problem stems from:
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Hospital closures—136 rural hospitals in the U.S. shuttered between 2010 and 2021 due to staffing and financial strains.
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Physician shortages—only 9% of doctors practice in rural areas, despite 20% of the population living there; projections suggest these shortages will worsen.
- Other healthcare workforce shortages: Pennsylvania faces significant shortages of nurses, and mental health professionals, according to AARP. This is particularly true in rural areas where it’s difficult to attract and retain healthcare professionals.
And thus, a canine attack in such communities doesn’t just inflict physical harm. Rather, the effects may cascade into complications if specialized medical follow-up or emergency services aren’t locally accessible.
How Do Those in Underserved Areas Gain Access to Treatment?
Understand that immediate first aid is crucial. Here are some ideas:
Clean the wound thoroughly
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Use soap and copious clean or saline water. High-pressure irrigation (using, e.g., a 20 mL syringe or catheter) significantly reduces infection risk.
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Carefully explore the wound to identify any penetration to deeper structures like tendons or bones; imaging may be needed if there’s concern.
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Don’t wait—delays beyond 6 hours dramatically increase infection risk, with one study noting infection jumped from 8% when treated promptly to 59% when delayed.
Start Antibiotics When Appropriate
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For high-risk wounds—such as those on hands, deep punctures, crush injuries, or delayed presentation—prophylactic antibiotics are strongly recommended.
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Amoxicillin‑clavulanate (Augmentin) is the preferred antibiotic. Alternatives depend on allergies or age.
Don’t Skip Rabies and Tetanus Considerations
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All dog bites should prompt evaluation for rabies post‑exposure prophylaxis (PEP). If the dog’s vaccination status is unknown or observation isn’t feasible, PEP should begin promptly.
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For tetanus, ensure your immunization is up to date—especially if the bite is deep or dirty.
Use Telehealth When Travel Isn’t Feasible
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Telemedicine can help in rural regions, offering access to virtual consultation, wound evaluation, and prescription support. Pennsylvania has expanding tele-health policies supporting virtual delivery of physical health services. -
Setting up access with providers such as UPMC AnywhereCare or AHN Virtual Visits in advance may prove crucial.
Prioritize Emergency Services When Needed
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Severe bites—those with heavy bleeding, deep tissue involvement (e.g., bone, joints, face), or early signs of infection—require urgent or emergency care. Call 911 right away despite the shortage of care. Or, arrange transport yourself ASAP, even if it’s distant.
Report the Bite to Authorities
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In Pennsylvania, medical professionals are required to report animal bites to public health authorities. The Department of Health handles rabies guidance and may advise on animal testing or quarantine. Click here to learn more about local reporting.
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However, your department of health may face a shortage of animal control workers to follow up. So, you should inquire with the canine owner whether the animal had its vaccinations. And, if not, seek treatment for rabies.
- Absent vaccination, you may have a claim against the pet owner for putting you at risk of disease. For more, click here.
Prepare for Future Emergencies
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Keep a well-stocked first-aid kit at home, including saline, antibiotic ointment, dressings, and antiseptic.
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Know your nearest clinic or urgent care’s location and hours, and save contact information for tele-health services and your county health office.
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If transport is an issue, explore community resources such as local volunteer rides, church networks, or social services.
Closing Thoughts
Rural healthcare shortages in Western Pennsylvania pose certain problems. However, prompt local action—cleaning the wound, using antibiotics when indicated, leveraging telemedicine, and knowing when to escalate care—can make a real difference in outcomes following a canine-caused injury.
Let’s Get Started!
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