Date of Original Release: February 1, 2022. Date of most recent review: May 10, 2022. Termination date: June 1, 2025.
Accreditation: EB Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. This activity has been planned and implemented in accordance with the accreditation requirements and policies of the ACCME.
Credit Designation: EB Medicine designates this enduring material for a maximum of 4 AMA PRA Category 1 CreditsTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Specialty CME: Included as part of the 4 credits, this CME activity is eligible for 4 Infectious Disease CME credits, subject to your state and institutional requirements.
Needs Assessment: The need for this educational activity was determined by a practice gap analysis; a survey of medical staff; review of morbidity and mortality data from the CDC, AHA, NCHS, and ACEP; and evaluation responses from prior educational activities for urgent care and emergency medicine physicians.
Target Audience: This internet enduring material is designed for physicians, physician assistants, nurse practitioners, and residents in the urgent care and family practice settings.
Goals: Upon completion of this activity, you should be able to: (1) identify areas in practice that require modification to be consistent with current evidence in order to improve competence and performance; (2) develop strategies to accurately diagnose and treat both common and critical ED presentations; and (3) demonstrate informed medical decision-making based on the strongest clinical evidence.
CME Objectives: Upon completion of this activity, you should be able to (1) describe the risk factors for acquisition of rabies in the United States and in returning travelers and migrants; (2) list the indications for rabies pre- and postexposure prophylaxis based on the current CDC Advisory Committee on Immunization Practices guidelines; (3) explain the clinical presentation of rabies and how it is differentiated from other acute neurologic disorders; and (4) describe the diagnostic and management principles for patients potentially exposed to rabies, as well as those with suspected clinical rabies.
Discussion of Investigational Information: As part of the activity, faculty may be presenting investigational information about pharmaceutical products that is outside Food and Drug Administration approved labeling. Information presented as part of this activity is intended solely as continuing medical education and is not intended to promote off-label use of any pharmaceutical product.
Faculty Disclosure: It is the policy of EB Medicine to ensure objectivity, balance, independence, transparency, and scientific rigor in all CME activities. All faculty participating in the planning or implementation of a CME activity are expected to disclose to the participants any relevant financial relationships and to assist in mitigating the relationships. In compliance with all ACCME accreditation requirements and policies, all faculty for this CME activity were asked to complete a full financial disclosure statement. The information received is as follows: Update Contributors (June 2022): the author and Editor-in-Chief, Dr. Keith Pochick; and peer reviewer, Dr. Claude Shackelford, report no relevant financial relationships with ineligible companies. The charting tips author, Dr. Patrick O’Malley, reported receiving royalty payments from Medline Industries. This relationship has been mitigated by faculty attestation and peer review. Original Contributors (April 2021): The information received is as follows: Dr. Storch, Dr. Chu, Dr. Otten, Dr. Toscano, Dr. Mishler, Dr. Jagoda, and their related parties report no significant financial interest or other relationship with the manufacturer(s) of any commercial product(s) discussed in this educational presentation.
Commercial Support: This issue of Evidence-Based Urgent Care did not receive any commercial support
Earning Credit: Go online to www.ebmedicine.net/CME and click on the title of the test you wish to take.When completed, a CME certificate will be emailed to you.
Hardware/Software Requirements: You will need a computer, tablet, or smartphone to access the online archived article, podcast, and CME test.
Additional Policies: For additional policies, including our statement of conflict of interest, source of funding, statement of informed consent, and statement of human and animal rights, visit www.ebmedicine.net/policies.
Although clinical rabies is rare in the United States, potential exposures are not uncommon, and missing an exposure could lead to a uniformly fatal outcome.
Ask about and document any animal exposures for patients who have returned from endemic areas (eg, India, Africa, Asia).
Properly refer all patients who will be traveling to endemic areas to the health department or a travel medicine clinic for PrEP.
For a known animal exposure, bite, or skin injury, perform and document aggressive cleansing with iodine-containing solutions.
Ask about and document any situation in which a bat may have been present in a closed space, or any encounter (indoors or outdoors) that involved contact with a bat.
Document the rabies status of the involved animal, if possible, as well as the location of the incident and notification of animal control.