173. 3 steps in rabies prophylaxis December 30th, 2007 by reuben in animal bite Back Top Tags: card 172. Rabies PEP after bite from dog/cat/ferret / skunk/raccoon/fox/other carnivores/bats / livestock/lagomorphs/rodents/other mammals 174. Case definition of AIDS / HIV RF / Proven modes of HIV transmission Responses to “173. 3 steps in rabies prophylaxis” These are the new recommendations, courtesy of Keeping Up in Emergency Medicine. Unvaccinated patients – Wound cleansing – HRIG ? 20 IU/kg. Administer as much as possible around the wounds and the rest IM at a site distant from the vaccine administration site. Do not administer more than the recommended dose. – Rabies vaccine- 1mL IM in the deltoid (or later thigh in small children- not gluteal) at days 0,3,7,14. If patient is immunocompromised, continue to give the 5th dose at day 28. If patient is previously vaccinated with a documented history of antibody response to prior vaccination, you don’t give the HRIG; just give 1mL of rabies vaccine on day 0 and 3. These recommendations are different from what the instructions that are included in the packaging of the vaccine. reuben at 2010-04-03 12:53 Leave a Reply Cancel reply Please post any discussion to the emupdates Reddit page.