Where to administer gamma globulin after a tick bite? - briefly
Administer the gamma globulin intramuscularly in the deltoid muscle at a medical facility, and do so promptly after the tick bite.
Where to administer gamma globulin after a tick bite? - in detail
Gamma‑globulin for tick‑bite prophylaxis is administered by injection into muscle tissue. The preferred anatomical locations depend on patient age and body habitus:
- Adults and adolescents: deltoid muscle of the upper arm, positioned 2–3 cm below the acromion, avoiding the humeral head.
- Children weighing less than 20 kg: anterolateral thigh (vastus lateralis), at the mid‑point between the greater trochanter and the patella.
- Obese patients or those with limited deltoid muscle mass: gluteal region (upper outer quadrant) may be used, provided the injection avoids the sciatic nerve.
The injection must be performed in a sterile environment, using a 21‑23 G needle, length 1‑1.5 inches for deltoid or gluteal sites, and 1‑1.25 inches for the thigh. The following steps ensure correct administration:
- Verify patient identity, indication, and contraindications (e.g., IgA deficiency, severe allergic reaction to blood products).
- Clean the injection site with an alcohol swab; allow it to dry.
- Pinch the muscle tissue to elevate it from underlying structures.
- Insert the needle at a 90° angle, aspirate gently to confirm absence of blood.
- Deliver the prescribed volume steadily; withdraw the needle promptly.
- Apply gentle pressure with a sterile gauze; cover with a small adhesive bandage if needed.
- Observe the patient for at least 15 minutes for any immediate adverse reaction.
Timing is critical; the dose should be given as soon as possible, ideally within 72 hours of the tick bite, to achieve optimal passive immunity against potential tick‑borne pathogens. Documentation must include the injection site, needle size, dose, lot number, and any observed side effects.