For a tick bite, how is immunoglobulin administered? - briefly
Immunoglobulin is infiltrated directly into and around the tick bite site, with any remaining volume administered intramuscularly, typically in the deltoid muscle. This dual‑site approach ensures rapid local neutralization and systemic distribution.
For a tick bite, how is immunoglobulin administered? - in detail
When a tick attachment raises concern for rabies exposure, passive immunization with rabies immune globulin (RIG) is administered promptly. The protocol consists of two distinct injections:
- Infiltration around the bite site – the calculated dose of RIG is divided, and as much as possible is injected directly into and surrounding the wound. This delivers antibodies to the exact entry point of the virus.
- Intramuscular injection in the deltoid – the remainder of the dose is given into a muscle of the opposite arm, ensuring systemic distribution.
The total RIG dose equals 20 IU per kilogram of body weight, not to exceed 2,500 IU. The product must be administered within 24 hours of the incident; delays reduce efficacy. RIG should be used only once per exposure, and it must be followed by the full rabies vaccine series on days 0, 3, 7, 14, and 28 (or the accelerated schedule of days 0, 3, 7, 14 for immunocompromised patients).
Key procedural points:
- Verify that the preparation is human or equine-derived RIG approved for post‑exposure prophylaxis.
- Calculate the exact volume based on the patient’s weight; use a sterile syringe and needle appropriate for intradermal infiltration and intramuscular injection.
- After wound infiltration, observe the site for local reactions; document any pain, swelling, or erythema.
- Record the administration time, dose, and product lot number in the patient’s medical record.
- Schedule the first vaccine dose immediately after RIG administration; ensure adherence to the subsequent dosing schedule.
Contraindications include known hypersensitivity to the specific RIG preparation. In patients with severe allergic history, an alternative passive immunization strategy—such as monoclonal antibody products—may be considered, following the same wound‑infiltration principle. Monitoring for adverse events, particularly serum sickness or anaphylaxis, should continue for at least 30 minutes post‑injection.