Sampleletter:Lettertohealthcareproviderregardingrabiespostexposureprophylaxisadministration

Date: DearHealthCareProfessional:

Re:DOB//(yy/mm/dd)

Thefollowingoutlinestheprotocolforrabiespost-exposureprophylaxis(RPEP).RPEPconsistsofaseriesofrabiesvaccineandonedoseofrabiesimmuneglobulin.AdditionalinformationcanbefoundinthepackageinsertsfortheseproductsorintheCanadianImmunizationGuide.

Pleasenotethattheseproductsmustremainrefrigerated(between2-8°C)atalltimesandshouldonlybehandledandstoredwherethiscanassured.Ifthistemperaturehasnotbeenmaintained,pleasecontactmeimmediately.

RABIESVACCINE(HDCVorPCECV):
Series: / Forimmunocompetentpersonspreviouslynotimmunized:Thefirstdoseofrabiesvaccineisgivenassoonaspossibleafterexposure(day0).Subsequentdosesaregivenondays3,7and14daysafterthefirstdoseonday0.
Forimmunocompromisedpersonsandthosetakingchloroquineandotherantimalarials,previouslynotimmunized:Thefirstdoseofrabiesvaccineisgivenassoonaspossibleafter
Dose: / exposure(day0).Subsequentdosesaregivenondays3,7,14and
28daysafterthefirstdoseonday0
Eachdoseis1mlintramuscularly(IM)
Site: / Vaccineshouldbeadministeredintothedeltoidmuscleinchildrenandadults(neverintheglutealregion)orintotheanterolateralupperthighininfantsunder1yearof age.
Administration: / Reconstitutevaccinewithneedleandsyringeprovided.Administervaccineusinganewsyringeandappropriateneedle(25gaugeandappropriatelengthforIMinjection–usually1 or1.5inch)
Day0-FirstDose / Datedue:
Day3-SecondDose / Datedue:
Day7-ThirdDose / Datedue:
Day 14-FourthDose / Datedue:
Day28-FifthDose
(onlyfor immunocompromisedandforthosetakingchloroquineandotherantimalarials) / Datedue:

RABIESIMMUNE GLOBULIN (RIG):

Series: / AsingledoseofRIGisgivenassoonaspossibleafterexposure(day0).
Dose: / Thedoseofrabiesimmuneglobuliniscalculatedbasedonweightinkilograms.Thevolumecalculatedbasedonweightshouldnotbeexceededbecauseofpossibleinterferencewithactiveantibodyproduction.
ThedoseofRIGinmLsiscalculatedas:[20IU/kg)XWeight(kg)]/150(IU/mL)
WehavecalculatedtheRIGdoseforthisclienttobe_mLsusing_kgastheweight.Youwillbeshipped_vials ofRIG(eachvialcontains2mLs).Theclient’sweightshouldbeconfirmedpriortoRIGadministration.
Site: / InfiltrateasmuchRIGaspossiblearoundthewoundsiteinordertoneutralizethevirus.Whenmorethanonewoundsiteexists,eachshouldbelocallyinfiltratedwithaportionof theRIG.Becauseofthelarge volumetobeinjected,theremainderoftheRIGshouldbegivenIMintheglutealarea,deltoidortheanterolateralthighmuscle.Ifthereisno woundsite,alloftherabiesimmuneglobulinshouldbegivenIM.
Administration: / DuetothethicknessofRIG,drawupandadministerRIGusinga21gaugeneedle(s)andappropriatelength(s)forwoundinfiltrationandIMinjection.Undernocircumstancesshouldrabiesvaccinebeadministeredinthesamesyringeoratthesamesiteasrabiesimmuneglobulin.

TETANUS:

Tetanusprophylaxisisalsoanimportantconsiderationandtheopportunitytoupdatetetanusimmunizationshouldnotbemissedifindicated.

Ifyouhaveanyquestionsorconcernspleasecontact:Yours truly,

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