Rabies: Difference between revisions

Revision as of 05:16, 28 March 2011

Indication for Prophylaxis

Bite or salivary exposure from bat, or mammalian carnivore
Inhalation counts (e.g. dead bat in room)

^Not needed if non-salivary exposure, or if bird, reptile, or rodent (rare cases)

^Call CDC if questions

Workup

Was animal captured?

Yes
1. Is animal dog or cat?
  1. Yes: Observe 10 days, if abnormal, sacrifice and treat with vacc and RIG
    1. discontinue if animal negative path for rabies
  2. No: Sacrifice animal and begin RIG and vaccine
    1. discontinue if animal negative path for rabies
No
1. Is Animal dog or cat?
  1. Yes: Give vacc and RIG only if rabies risk for species in area
  2. No: Treat with full course vacc and RIG

Treatment

Clean wound
Rabies vaccine: human diploid cell vaccine (HDCV): 1ml IM* Day 0, 3, 7, 14,and 28
1. Give in deltoid not buttock (since Ab not created in fat cells)
2. If previously immunized: HDCV on day 0, 3; no RIG
RIG (rabies immune globulin): 20 IU/kg (infiltrated SC around wound) if possible
1. place remainder opposite arm of vaccine
2. can administer up to 7 days after the first vaccine dose

Authors:

@@ Line 1: / Line 1: @@
-Indication for Prophylaxis* Bite or salivary exposure from bat, or mammalian carnivore* Inhalation counts (e.g. dead bat in room)
+Indication for Prophylaxis
+* Bite or salivary exposure from bat, or mammalian carnivore
+* Inhalation counts (e.g. dead bat in room)
-* Not needed if non-salivary exposure, or if bird, reptile, or rodent (rare cases)
+^Not needed if non-salivary exposure, or if bird, reptile, or rodent (rare cases)
-* Call CDC if questions
-==Was animal captured?==
+^Call CDC if questions
-===Yes:===
-     Is animal dog or cat?
-          Yes: Observe 10 days, if abnormal, sacrifice and treat with vacc and RIG
-               discontinue if animal negative path for rabies
-          No: Sacrifice animal and begin RIG and vaccine
-               discontinue if animal negative path for rabies
-===No:===
-     Is Animal dog or cat?
-          Yes: Give vacc and RIG only if rabies risk for species in area
-          No: Treat with  full course vacc and RIG
-Treatment* Clean wound
-* Rabies vaccine: human diploid cell vaccine (HDCV): 1ml IM* Day 0, 3, 7, 14,and 28
-* Give in deltoid not buttock (since Ab not created in fat cells)
-* If previously immunized: HDCV on day 0, 3; no RIG
-* RIG (rabies immune globulin): 20 IU/kg (infiltrated SC around wound) if possible* place remainder opposite arm of vaccine
-* can administer up to 7 days after the first vaccine dose
+===Workup===
+Was animal captured?
+#Yes
+##Is animal dog or cat?
+###Yes: Observe 10 days, if abnormal, sacrifice and treat with vacc and RIG
+####discontinue if animal negative path for rabies
+###No: Sacrifice animal and begin RIG and vaccine
+####discontinue if animal negative path for rabies
+#No
+##Is Animal dog or cat?
+###Yes: Give vacc and RIG only if rabies risk for species in area
+###No: Treat with  full course vacc and RIG
+==Treatment==
+# Clean wound
+# Rabies vaccine: human diploid cell vaccine (HDCV): 1ml IM* Day 0, 3, 7, 14,and 28
+## Give in deltoid not buttock (since Ab not created in fat cells)
+## If previously immunized: HDCV on day 0, 3; no RIG
+# RIG (rabies immune globulin): 20 IU/kg (infiltrated SC around wound) if possible
+##place remainder opposite arm of vaccine
+##can administer up to 7 days after the first vaccine dose
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