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Transfusion products
Published in Jennifer Duguid, Lawrence Tim Goodnough, Michael J. Desmond, Transfusion Medicine in Practice, 2020
The available specific preparations are as follows: Hepatitis B immunoglobulin, given alongside vaccination in individuals accidentally inoculated with the virus and to infants born to mothers who have been infected during pregnancy or who are high-risk carriersRabies immunoglobulin, given alongside vaccination to individuals who are unimmunized and have been exposed to an animal from a high-risk countryTetanus immunoglobulin, if an individual is non-immune and wound soiling is severeVaricella zoster immunoglobulin, for primary infection in immunosuppressed individuals, including those treated with steroidsAnti-D immunoglobulin for the treatment of RhD haemolytic disease of the newborn
Rabies
Published in Meera Chand, John Holton, Case Studies in Infection Control, 2018
Martine Usdin, Hilary Kirkbride, Kevin E Brown
Postexposure treatment with rabies vaccine and human rabies immunoglobulin (PET) is highly effective if initiated promptly following exposure, and it should be initiated as soon as possible following an individual risk assessment for all those assessed as exposed. When assessing a potentially exposed patient for rabies risk, several factors should be taken into account: species of animalthe country of origincurrent health status of the animalnature of exposureimmunity of individual exposed
Clinical features and management of animal bites in an emergency department: a single-center experience
Published in Postgraduate Medicine, 2023
Orkun Aydin, Elif Tugce Aydin Goker, Zeynep Aybuke Arslan, Halil Mustafa Sert, Ozlem Teksam
Multiple dog attacks are a significant cause of severe animal bite injuries. These patients are possible candidates for surgical interventions besides routine prophylaxis practices. In these patients, the injuries may be more severe and deeper. These wounds are difficult to clean, and multiple wounds in different body parts increase the risk of infection. Applying rabies immunoglobulin to wound edges can be challenging since the amount of immunoglobulin might be insufficient, and dilution with normal saline might be required. More complicated injuries should be managed in consultation with an appropriate surgical specialist. Cranial penetrating bite wounds to the scalp and skull carry a high risk for intracranial infection. Head imaging is recommended to examine the possible penetration of the skull in these cases.
Child survivor of rabies in India: a case report
Published in Paediatrics and International Child Health, 2020
Biju John, Shyam Kumar, Sudeep Kumar, S. S. Dalal, Aneesh Mohimen
In India, appropriate post-exposure rabies prophylaxis has been limited by a lack of awareness of first aid, accurate dog-bite classification, follow-up vaccination and less than satisfactory availability of vaccine and immunoglobulin [13]. It is important to emphasise that a WHO Class III bite is constituted by ‘Single or multiple transdermal bites or scratches, contamination of mucous membrane or broken skin with saliva from animal licks, exposure due to direct contact with bats (severe exposure)’, especially with bites on the head, neck, face, hands and genitals because of the rich innervation of these areas [1]. Presently, a number of cell culture rabies vaccines including purified chicken embryo cell vaccine, purified vero cell vaccine and purified duck embryo vaccine are available in India. The options for anti-rabies globulin include equine rabies immunoglobulin, human rabies immunoglobulin and monoclonal antibodies [14].
Multi-Patient Rabies Exposure on a Colorado River Rafting Expedition: Urgent vs. Emergent Transport Decision Making in an Austere Setting
Published in Prehospital Emergency Care, 2018
Emily A. Pearce, Aaron N. Farney, Laura Banks, Andrew J. Harrell
Post-exposure management consists of local wound care, tetanus vaccination, antibiotics if indicated, and consideration for PEP.20 The wound should be copiously irrigated for at least 15 minutes as soon as possible after the bite is sustained; this dramatically reduces the viral load and can be life-saving.20,21 PEP consists of human rabies immunoglobulin injection at the bite site and multiple doses of intramuscular rabies vaccination as soon as possible after exposure.20 In general, if the suspicion for rabies is low and the offending animal can be quarantined or tested, PEP may be deferred pending results.20,22 However, if suspicion for rabies is high, or the offending animal is unavailable for quarantine or testing, PEP is generally advised. For exposures to potentially rabid bats, the CDC recommends PEP be administered for any known bat bite, scratch, or mucous membrane exposure. The CDC also recommends PEP be considered if there is any possible contact with a bat, including one being found in the room with a child or incapacitated or sleeping adult even if there is no known bite.20,22 Decisions to administer or withhold PEP should be made in conjunction with the local public health department and the CDC's guidelines.20,22 Although PEP is 100% effective if initiated in a timely manner, it is generally not effective once the patient becomes symptomatic.20,22