Multiple human bites on a 17f year old. Approximately 20 hours ago.

The age of the person who bit them is a 9 and a half year old female. The 9 year old was throwing and attacking their mother and raging about killing them and the 17 year old tried to restrain her to protect their mom. The 9 year old proceeded to repeatedly bite and scratch at the 17 year old, chomping and shaking as hard as they could. Eventually the child calmed down and the mom took the older child to another room to photograph the injuries and provide comfort to the teen. The teen may have had a tetanus shot in the last 5 years, mom doesn’t remember exactly, but knows they had one. They have been at their wits end with the violent outbursts from the 9 year old, and the child actually just started menstruating this week for the first time, so that could be adding to her behavior problems. I’m concerned about my friend, her teen and the family in general and my friend is so overwhelmed she doesn’t know what she should do. Do these bites look concerning? The after photos are from 20 hours after the incident. I’ll put them in the comments.