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Rabies

WHAT YOU SHOULD KNOW:

Rabies is a disease caused by a virus that affects the body's central nervous system. The central nervous system is made up of the brain, spinal cord, and nerves. The rabies virus most often spreads through the bite of an animal. Animals that may spread rabies include dogs, cats, coyotes, raccoons, foxes, skunks, and bats.


CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

Rabies vaccinations may cause headaches, muscle aches, or fever. The area where the shot was given may be painful, red, swollen, or itchy. You may get rabies even after you have the rabies shot. Immune globulin medicine can cause pain and a fever. Bite wounds can damage nerves and tendons in the body. Bite wounds can also cause an infection in the area of the wound, or in the bloodstream. Without early treatment, rabies damages the brain and other organs. You may have brain swelling, seizures, and paralysis (being unable to move). Rabies can be life-threatening.

WHILE YOU ARE HERE:

Informed consent

is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

Isolation:

You may be put on isolation safety measures if you have an infection or disease that may be given to others. Caregivers and visitors may need to wear gloves, a face mask, or a gown. Visitors should wash their hands before leaving to keep from spreading germs.

Medicines:

You may be given the following medicines:

  • Vaccine: A rabies vaccine is given to help your body make antibodies to fight the virus and help prevent rabies. The vaccine may be given before caregivers know that you have been exposed to rabies (preexposure). It also can be given when caregivers learn that you have been exposed to rabies (postexposure).

    • If you have been exposed to the rabies virus and you have not been given the vaccine in the past, you will be given 4 different doses. These will be given on 4 different days within a 1-month period. You will also be given a shot of rabies immune globulin.

    • If you have been given the rabies vaccine in the past and have now been exposed to the virus, you will receive 2 doses, given 3 days apart.

    • If you are at risk of being exposed to rabies, you will be given 3 doses on different days. These are given within a 1-month period.

  • Rabies immune globulin: If you have been exposed to rabies, you may be given rabies immune globulin to attack the virus. This medicine will also help your immune system fight the infection. If you have been given the rabies vaccine in the past, you will not be given this medicine.

  • Anticonvulsant medicine: This medicine is given to control seizures. Take this medicine exactly as directed.

  • Antiviral medicine: This is given to prevent or treat an infection caused by a germ called a virus. Antiviral medicine may also be given to control symptoms of a viral infection that cannot be cured.

  • Pain medicine: Caregivers may give you medicine to take away or decrease your pain.

    • Do not wait until the pain is severe to ask for your medicine. Tell caregivers if your pain does not decrease. The medicine may not work as well at controlling your pain if you wait too long to take it.

    • Pain medicine can make you dizzy or sleepy. Prevent falls by calling a caregiver when you want to get out of bed or if you need help.

  • Sedative: This medicine is given to help you stay calm and relaxed.

  • Steroids: This medicine may be given to decrease inflammation.

  • Td vaccine: This vaccine is a booster shot used to help prevent diphtheria and tetanus. The Td booster may be given to adolescents and adults every 10 years or for certain wounds and injuries.

Wound care:

If you have a bite wound, caregivers will clean it well and do other treatments if needed. Your risk of infection and rabies decreases if your wound is cleaned soon after you are bitten. Caregivers may close the wound using stitches.

Heart monitor:

This is also called an ECG or EKG. Sticky pads placed on your skin record your heart's electrical activity.

Neurologic exam:

This is also called neuro signs, neuro checks, or neuro status. A neurologic exam can show caregivers how well your brain works after an injury or illness. Caregivers will check how your pupils (black dots in the center of each eye) react to light. They may check your memory and how easily you wake up. Your hand grasp and balance may also be tested.

Respiratory support:

  • You may need extra oxygen if your blood oxygen level is lower than it should be. You may get oxygen through a mask placed over your nose and mouth or through small tubes placed in your nostrils. Ask your healthcare provider before you take off the mask or oxygen tubing.

  • A ventilator is a machine that gives you oxygen and breathes for you when you cannot breathe well on your own. An endotracheal (ET) tube is put into your mouth or nose and attached to the ventilator. You may need a trach if an ET tube cannot be placed. A trach is a tube put through an incision and into your windpipe.

Tests:

  • Biopsy: Your caregiver may do a skin biopsy on you. A biopsy is done by removing a small piece of tissue and then sending it to the lab for tests. A skin sample is usually taken from the back of the neck. A biopsy can help caregivers learn the cause of your symptoms.

  • Blood tests: You may need blood taken to give caregivers information about how your body is working. The blood may be taken from your hand, arm, or IV.

  • Culture: This is a test to grow and identify the germ that is causing your illness. Samples may be taken from your saliva, tears, or fluid in the brain and spine.

  • Lumbar puncture: This procedure may also be called a spinal tap. During a lumbar puncture, you will need to lie very still. Caregivers may give you medicine to make you lose feeling in a small area of your back. Caregivers will clean this area of your back. A needle will be put in, and fluid removed from around your spinal cord. The fluid will be sent to a lab for tests. The tests check for infection, bleeding around your brain and spinal cord, or other problems. Sometimes medicine may be put into your back to treat your illness.

  • MRI: This scan uses powerful magnets and a computer to take pictures of your brain. It will also take pictures of the blood vessels and structures in your head. You may be given dye, also called contrast, before the test. Tell caregivers if you are allergic to dye, iodine, or seafood. Remove all jewelry, and tell caregivers if you have any metal in or on your body. Metal can cause serious injury. Tell caregivers if you cannot lie still or are anxious or afraid of closed spaces.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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