90377 Rabies immune globulin, heat- and solvent/detergent-treated (RIg-HT S/D), human, for intramuscular and/or subcutaneous use

Name of the Procedure:

Rabies Immune Globulin, Heat- and Solvent/Detergent-Treated (RIg-HT S/D), Human, for Intramuscular and/or Subcutaneous Use

Summary

The Rabies Immune Globulin (RIg-HT S/D) injection is a treatment used to provide immediate, passive immunity to prevent rabies infection after a suspected rabies exposure, such as an animal bite. This treatment is administered into the muscles (intramuscular) or just under the skin (subcutaneous).

Purpose

The RIg-HT S/D procedure aims to prevent rabies, a deadly viral infection, following potential exposure. The goal is to deliver antibodies that neutralize the rabies virus until the body can develop its own immune response through the rabies vaccine.

Indications

• Exposure to the rabies virus, typically through an animal bite or scratch, or contact with infected saliva.
• Patients who have not previously received rabies vaccination.
• Immediate prophylactic treatment post-exposure.

Preparation

• No specific fasting or medication adjustments are usually required before the procedure.
• The patient should report any allergies, especially to human blood products or medication.
• An assessment of the wound and general health will be conducted.

Procedure Description

1. The healthcare provider will clean and assess the wound area.
2. The appropriate dose of RIg-HT S/D is calculated based on the patient’s weight.
3. The RIg-HT S/D is administered:
   • Intramuscularly (often in the thigh, gluteal muscle, or deltoid muscle).
   • Subcutaneously, if necessary, directly around the wound site.
4. The remaining dose (if any) is injected intramuscularly in a site away from the rabies vaccine injection site.

Tools/Equipment:

• Syringes, needles, and sterile gloves.
• Antiseptic solution for skin disinfection.

Anesthesia/Sedation:

• Local anesthesia may be used at the injection site for patient comfort, though it's not always necessary.

Duration

The procedure typically takes about 20 to 30 minutes.

Setting

• The procedure is commonly performed in a hospital emergency room, outpatient clinic, or a primary care setting.

Personnel

• The procedure is usually performed by a registered nurse or physician.

Risks and Complications

• Common risks include pain at the injection site, redness, and swelling.
• Rare risks include allergic reactions, fever, and local infection.
• Management of complications involves symptomatic treatment and monitoring.

Benefits

• Provides immediate passive immunity against rabies.
• Can be lifesaving when administered promptly after exposure.
• Benefits are typically realized quickly, within hours of administration.

Recovery

• Post-procedure, patients are advised to monitor the injection site for signs of infection or adverse reactions.
• Avoid strenuous activity or heavy lifting for 24 hours.
• Schedule follow-up visits as recommended for the rabies vaccine series.

Alternatives

• The primary alternative is the rabies vaccine alone, but it is less effective immediately without RIg-HT S/D.
• Delaying or forgoing treatment is not recommended due to the high fatality rate of rabies.

Patient Experience

• Patients might feel discomfort or soreness at the injection site.
• Mild pain can be managed with over-the-counter pain relievers like acetaminophen (Tylenol).
• Some patients may experience anxiety related to injections, which can be alleviated with supportive care and reassurance from healthcare professionals.