Background and Objective: Rabies is zoonosis with
high mortality rates. The post-exposure management
of patients at risk impact to spreading in human. So
we aimed to study the percentage of appropriateness
in post-exposure management of patients at risk to
rabies by using 2013 Rabies practice guideline of
Department of Disease Control, Ministry of Public
Health, Thailand.
Material and Methods: A retrospective descriptive
study enrolled patients who visited Srinagarind hospital
between January to December 2014 by using
International Classification of Diseases and Related
Health Problem 10th revision (ICD-10) code T14.1,
W50-W55, Z24.2.
Results: After searching by ICD-10 codes, 2009 patients
were enrolled and only 960 cases met our criteria.
Five hundred thirty six cases (55.8%) were women.
The average age was 35.8 years old and average duration
from exposure to medical contact was 13.4
hours. The most common carriers were dog (66.0%)
and the characteristics of exposure were biting at leg
or hand and 461 wounds (48.0%) were level III that
classified by World Health Organization (WHO)
category. But there were only 806 cases that contained
enough data in medical record to decide
appropriateness in post-exposure management.
Finally, we found the overall appropriate management
was 48.3%, appropriate rabies vaccine was 95.2%, and
appropriate rabies immunoglobulin was 91.1%. Conclusion: The post-exposure management of
patients at risk to rabies by 2013 Rabies practice
guideline was proper at 48.3%. Emergency physicians
need to update the post-exposure management of
patient at risk to rabies and complete the important
data in medical record for patient safety
Keywords
The post-exposure prophylaxis Rabies Appropriateness Practice guideline