Administering PET | Right Decisions

Where treatment takes place

Treatment	Adults	Children
HRIG and D0 vaccine	Emergency department	Emergency department
D3	Mon-Fri: Immunisation service Sat-Sun: Emergency department	Paediatric ward
All other doses	Immunisation service	Paediatric ward

NB: Day 0 and day 3 vaccine must be given on time – if day 3 vaccine due on Saturday/Sunday this needs to be administered in the OOH setting providing first dose

How to administer PET

Treatment

Dose

Adverse reactions (inform patient)

Rabies vaccine

(Rabipur)

1 vial, IM to deltoid

Injection site: redness, swelling, pain within 24-48h.

NB: Rabies vaccine, when given as postexposure treatment, has NO CONTRAINDICATION.

Human Rabies

Immunoglobulin

(HRIG)

20 IU/kg, infiltrated in & around the cleansed wound.

Any remainder should be injected IM (on the opposite side to the vaccination site)

Local pain, low-grade fever.

Obtaining Rabies Vaccine and/or HRIG

Rabies vaccine

8 doses of Rabies vaccine are held in the emergency cupboard. This is replenished in hours by pharmacy stores.
Out of hours, if no vaccine is present in the emergency cupboard (or more than 8 doses need to be administered simultaneously) the on-call pharmacist can be contacted.

HRIG

8 vials of HRIG are held in the emergency cupboard.
On call pharmacy should be called prior to release of this for use. They will ensure replenishment of this in-hours.
If there is no HRIG available in FVRH, then HRIG is available at the below sites. Health Protection process states the person undertaking the clinical review should order the HRIG using the numbers below:

Site	Contact number (daytime)	Contact number (out of hours). Ask for on call pharmacist
Aberdeen Royal Infirmary	Vaccine Service Desk 01224 553223	0345 456 6000
Edinburgh Royal Infirmary	0131 242 2911	0131 536 1000
Glasgow Queen Elizabeth University Hospital	0141 452 2975	0141 201 1100

HRIG will be transported to the treating hospital with cost recovery of the transport from the holding site.
Each site holds 15 vials of 500 iu/ml vials of HRIG (enough for five adult doses).