Name of the Procedure:

Rabies vaccine, intradermal use
Common name(s): Rabies vaccine, Human Diploid Cell Vaccine (HDCV), Purified Chick Embryo Cell Culture Vaccine (PCEC)
Technical term: Intradermal Rabies Post-Exposure Prophylaxis (PEP)

Summary

The intradermal rabies vaccine is a preventive treatment given to individuals who may have been exposed to the rabies virus through animal bites or scratches. This procedure involves the administration of the vaccine directly into the skin's dermal layer to stimulate an immune response.

Purpose

The medical condition or problem it addresses:

• Rabies exposure is a serious and often fatal viral disease affecting the nervous system.

The goals or expected outcomes of the procedure:

• To prevent the onset of rabies after potential exposure.
• To stimulate the immune system to produce antibodies against the rabies virus.

Indications

Specific symptoms or conditions that warrant the procedure:

• Animal bites or scratches, especially from wild or unvaccinated animals.
• Exposure to saliva or tissues from a potentially rabid animal.

Patient criteria or factors that make the procedure appropriate:

• Individuals who have been bitten by, scratched by, or had open wound contact with an animal suspected of being rabid.

Preparation

Pre-procedure instructions for the patient:

• No specific fasting or dietary restrictions required.
• Inform healthcare providers about any allergies, especially to previous vaccines.

Any diagnostic tests or assessments required beforehand:

• Wound examination and assessment for signs of infection.
• Rabies risk assessment based on the type and location of the bite/exposure.

Procedure Description

Detailed step-by-step explanation of what the procedure involves:

1. The healthcare provider cleans the site of the bite or scratch.
2. Using a fine syringe and needle, the vaccine is injected into the dermal layer of the skin, usually on the forearm.
3. The injection site is observed for a short period to ensure there is no immediate allergic reaction.

Tools, equipment, or technology used:

• Syringe and fine needle
• Rabies vaccine (HDCV or PCEC)

Anesthesia or sedation details, if applicable:

• Typically, no anesthesia is required.

Duration

How long the procedure typically takes:

• The actual vaccine administration takes a few minutes. Including preparation and post-injection observation, the total time is around 15-30 minutes.

Setting

Where the procedure is performed:

• Hospital emergency department, outpatient clinic, or travel health clinic.

Personnel

Healthcare professionals involved:

• Nurses or trained healthcare providers administer the vaccine, with oversight from a physician if necessary.

Risks and Complications

Common and rare risks associated with the procedure:

• Pain, redness, or swelling at the injection site.
• Mild fever, headache, or general malaise.
• Rare but serious allergic reactions (anaphylaxis).

Possible complications and their management:

• Management of minor side effects with over-the-counter pain relievers.
• Immediate medical attention for severe allergic reactions.

Benefits

Expected benefits and how soon they might be realized:

• Prevention of rabies infection with a high success rate if administered promptly.
• Immunity starts to develop within days after the initial dose.

Recovery

Post-procedure care and instructions:

• Keep the injection site clean and dry.
• Monitor for any signs of allergic reactions or infection at the injection site.

Expected recovery time and any restrictions or follow-up appointments:

• No significant downtime. Normal activities can usually be resumed immediately.
• Multiple doses may be required on days 0, 3, 7, and 28.

Alternatives

Other treatment options available:

• Intramuscular rabies vaccine administration.

Pros and cons of alternatives compared to the described procedure:

• Intramuscular administration is more common and may be preferred in certain clinical settings.
• Intradermal administration uses less vaccine per dose, which can be more cost-effective and resource-efficient.

Patient Experience

What the patient might feel or experience during and after the procedure:

• Mild discomfort or stinging at the injection site during the procedure.
• Possible minor side effects like soreness, redness, or mild fever.

Pain management and comfort measures:

• Over-the-counter pain relief medications can help manage discomfort.
• Application of a cold pack to the injection site if swelling occurs.