Where should immunoglobulin be administered after a tick bite? - briefly
The immunoglobulin is infiltrated around the bite wound, and any remaining dose is given intramuscularly, preferably in the deltoid muscle of the opposite arm.
Where should immunoglobulin be administered after a tick bite? - in detail
Immunoglobulin used for rabies post‑exposure prophylaxis after a tick bite must be delivered directly into the tissue surrounding the bite wound. The product is infiltrated as far as practicable around the entire puncture site, ensuring that the antibody reaches the peripheral nerves at risk of viral entry. Any volume that cannot be placed locally should be administered intramuscularly at a site separate from the rabies vaccine injection, commonly the deltoid muscle of the opposite arm.
Key points for proper administration:
- Calculate the dose according to body weight (20 IU per kilogram of body weight).
- Use a sterile needle and syringe; a 22‑25 G needle is suitable for most bite sites.
- Inject the calculated volume gradually, spreading it evenly around the wound margins.
- Avoid injection into necrotic tissue, hematomas, or areas with poor blood supply.
- If multiple bite locations exist, distribute the immunoglobulin proportionally among all sites.
- After completing local infiltration, administer the remaining volume intramuscularly in a distant muscle (e.g., deltoid) to achieve systemic coverage.
- Observe the patient for any immediate adverse reactions, such as local swelling or hypersensitivity.
Following these steps maximizes the likelihood that the passive antibodies will neutralize rabies virus at the entry point, complementing the active immunity provided by the vaccine.