Philips Leanne, Young Megan K, Wallace Janet, Dobinson Hazel C
Children's Health Queensland, Queensland Children's Hospital, Brisbane, Queensland, Australia.
School of Nursing, Midwifery and Social Work, University of Queensland, Brisbane, Queensland, Australia.
J Paediatr Child Health. 2020 Mar;56(3):364-366. doi: 10.1111/jpc.14800. Epub 2020 Feb 11.
Measles continues to be a public health concern world-wide. Vulnerable individuals including those in which vaccinations is contraindicated, may be reliant on normal human immunoglobulin (NHIG) prophylaxis in an aim to prevent disease. This paper will summarise and discuss a tertiary paediatric hospital's clinical experience and the practicalities of administering intramuscular (IM) NHIG to paediatric patients as per the current measles prophylaxis guidelines in Australia. Following potential exposure within the emergency department, 17 paediatric patients (0-15 years) were recommended IM NHIG for prophylaxis. The dose of NHIG ranged from 0.6 to 15 mL and required multiple (2-8) injections. Two patients required sedation for staff to safely administer the injections. Staff involved with these cases reported administering multiple injections to paediatric patients to be a traumatising experience. They also expressed views that the injection of large volumes via the IM route was an impractical method of administration. Based on this experience, we recommend intravenous immunoglobulin be considered when large volumes of NHIG are recommended intramuscularly.
麻疹仍是全球公共卫生关注的问题。包括那些禁忌接种疫苗的弱势群体，可能依赖于注射正常人免疫球蛋白（NHIG）来预防疾病。本文将总结并讨论一家三级儿科医院的临床经验，以及按照澳大利亚当前麻疹预防指南给儿科患者肌内注射NHIG的实际情况。在急诊科有潜在暴露风险后，17名儿科患者（0至15岁）被建议肌内注射NHIG进行预防。NHIG的剂量为0.6至15毫升，需要多次（2至8次）注射。两名患者需要镇静以便工作人员安全地进行注射。参与这些病例的工作人员报告说，给儿科患者多次注射是一次痛苦的经历。他们还表示，通过肌内途径注射大量药物是一种不切实际的给药方法。基于这一经验，我们建议当建议大量肌内注射NHIG时，考虑使用静脉注射免疫球蛋白。
