I’ve not been exposed myself, but I’ve given rabies post-exposure prophylaxis many times in the ER over the years. We give HRIG (human rabies immune globulin) on day one (and only once), and we infiltrate in and around the wound as much as we can. It’s actually quite a bit (volume wise) for an adult. The rest we administer IM. We also give rabies vaccine on days one, three, seven, and fourteen. The vaccine is a piece of cake, as each one is just 1cc IM. But the immune globulin involves a buncha shots.
