How is immunoglobulin administered after a tick bite? - briefly
A single dose of rabies immune globulin is injected, with as much as possible infiltrated directly around the tick‑bite wound and the remaining volume given intramuscularly at a site distant from the bite. This provides immediate passive immunity while the active vaccine series begins.
How is immunoglobulin administered after a tick bite? - in detail
Immunoglobulin given after a tick bite is administered as passive prophylaxis to neutralize pathogens that may have been transmitted. The process follows a defined protocol:
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Indication assessment – Determine the species of tick, attachment duration, and regional prevalence of tick‑borne infections (e.g., tick‑borne encephalitis, rickettsial diseases). Only high‑risk exposures warrant immunoglobulin use.
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Product selection – Choose the appropriate hyperimmune globulin preparation (e.g., tick‑borne encephalitis immune globulin, rickettsial immune serum). Verify that the batch is within its expiration date and that the vial label matches the intended indication.
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Dosage calculation – Administer a dose based on body weight, typically 0.5 mL/kg for TBE‑IG, not exceeding the maximum volume recommended by the manufacturer. For adult patients, a standard single dose of 250 IU may be prescribed, adjusted for pediatric patients according to weight.
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Timing – Deliver the infusion as soon as possible, ideally within 24 hours of the bite. Delayed administration reduces efficacy because the pathogen may already have disseminated.
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Route of administration – Provide the immunoglobulin intravenously (IV) for rapid systemic distribution. In some protocols, a fraction (0.1 mL/kg) may be injected intramuscularly at a site distant from the tick bite to minimize local reactions.
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Infusion technique – Use a sterile, low‑dead‑space syringe and a 22‑gauge or larger catheter. Dilute the product in compatible crystalloid solution if the volume exceeds 5 mL to prevent high‑viscosity infusion. Infuse at a rate of 0.01 mL/kg per minute for the first 15 minutes, then increase to 0.05 mL/kg per minute, monitoring for adverse reactions.
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Monitoring – Observe the patient for at least 30 minutes post‑infusion. Record vital signs every 5 minutes during the initial phase and every 15 minutes thereafter. Watch for signs of hypersensitivity (urticaria, bronchospasm, hypotension) and manage immediately with antihistamines, bronchodilators, or epinephrine as indicated.
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Documentation – Note the tick species, bite location, time elapsed, product lot number, administered dose, infusion rate, and any adverse events. This record supports follow‑up care and epidemiological tracking.
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Follow‑up – Arrange a clinical review within 48 hours to assess wound healing and confirm that no systemic symptoms have emerged. If symptoms develop, initiate appropriate antimicrobial therapy based on the suspected pathogen.
Adhering to these steps ensures that passive immunization after a tick exposure is delivered safely, effectively, and in accordance with current clinical guidelines.