For preventive purposes Serum is injected intramuscularly as soon as possible after injury.
With a curative purpose serum is administered intravenously, very slowly, by drop method, usually in a mixture with a solution for injection of 0.9%, heated to the body temperature of sodium chloride, at the rate of 100-400 ml per 100 ml of serum.
Serum is heated to (36 ± 0.5) ° C and injected: first 1 ml for 5 minutes, then 1 ml per minute.
Serum is administered by a doctor, or under his supervision.
The amount of serum administered depends on the clinical condition of the patient.
Usually therapeutic dose serum antigangrenous is 150 thousand. ME:
- antiphrinter - 50,000 ME,
- anti-epidemiants - 50000 ME,
- antiseptic - 50,000 ME.
Before the introduction of serum anti-gangrenous, an intradermal test with a horse serum of diluted 1: 100 diluted (ampoule marked in red) is mandatory to check the sensitivity of the patient to horse serum proteins.
Serum horse purified diluted 1: 100 is injected in a volume of 0.1 ml intradermally into the flexor surface of the forearm (use syringes with a fission rate of 0.1 ml and thin needles).
The reaction is taken into account after 20 minutes. The sample is considered negative if the diameter of the edema and (or) redness appearing at the injection site is less than 1 cm. The sample is considered positive if the edema and (or) redness reaches a diameter of 1 cm or more.
With negative intracutaneous sample, serum anti-gangrenous (ampoule is marked in blue) is administered subcutaneously in an amount of 0.1 ml. In the absence of reaction after 30 minutes, the entire prescribed dose of serum is administered intramuscularly (for prophylactic purposes) or intravenously (for therapeutic purposes).
With a positive intradermal test, serum is administered only on unconditional indications under the supervision of a doctor and with special precautions. Initially, injected under the skin serum anti-gangrene, diluted in doses of 0.5 ml, 2.0 ml, 5.0 ml (diluted serum is prepared immediately before use, introducing 0.1 ml of serum antigangrenous in 9.9 ml of sodium chloride solution for injection 0 , 9%) with an interval of 20 minutes.In the absence of reaction to these doses, 0.1 ml serum antigangrenous is injected subcutaneously. In the absence of reaction after 30 minutes, all the prescribed amount of serum is administered intramuscularly (for prophylactic purposes) or intravenously (for therapeutic purposes). In the case of a positive reaction to one of the above doses, serum anti-gangrene is not injected or injected under anesthesia, having a syringe ready with a 0.1% solution of epinephrine hydrochloride or a 0.2% solution of noradrenaline hydrotartrate.
All manipulations are performed by separate sterile syringes. Opened ampoule with serum anti-gangrene, close with a sterile tissue, stored at a temperature (20 + 2) ° C not more than 1 hour. An uncovered ampoule with an equine serum diluted 1: 100 is not subject to storage.