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Administration of a cell-culture rabies vaccine (in the deltoid muscle only) on
days 0, 3, 7, 14, and 28.
All three elements are equally essential; deaths have occurred when any one was
neglected.
Travelers to regions where rabies is prevalent, which is most of the developing world,
should consider pre-exposure vaccination. Such prior immunization eliminates the need
for immune globulin following exposure, which is of major significance because only
about one-third of the immune globulin needed for postexposure therapy in now being
produced worldwide.
V. GUIDELINES FOR EVACUATION
Victims of large wild animal attack, even with stable vital signs, usually require rapid
evacuation from the field for surgical wound treatment, as well as multiple trauma
evaluation with diagnostic studies such as x-ray or computed tomography. Lesser
wounds or bites may require evacuation for antibiotic treatment, rabies prophylaxis,
cosmetic closure or wound exploration and cleaning.
If rescue and evacuation will require days versus hours, close observation of vital
signs, daily wound care with additional field irrigation, cleaning, debridement and
dressing change as needed and antibiotic administration is advised.
