Measles, Suspected Exposure or Infection — Administration Best Practice for Intramuscular Immune Globulin — Clinical Pathway

Suspected Measles Exposure or Infection Clinical Pathway — ED, Outpatient Specialty and Primary Care

Administration Best Practice for Intramuscular Immune Globulin

  • GamaSTAN dosing Infants and Children < 30 kg: 0.5 mL/kg IM, max 15 mL
    • Pregnant women without evidence of immunity, severely immunocompromised children, and children > 30 kg should receive IV immune globulin
  • Split doses to accommodate max volume based on age, site and body habitus
  • Can administer more than 1 injection in single limb if separated by > 1 inch (preferred site Vastus Lateralis)
  • Avoid gluteal injections due to risk of sciatic nerve injury and site-specific absorption rate
  • Aspirate blood prior to injection to ensure needle is not in blood vessel
  • Observe for 15-20 mins post administration for acute reaction
  • Use clinical judgment when choosing site, max volume
Age Injection Site Suggested Max Volume Needle Gauge/Length
Not for Immunization
Term newborn to 2 mos Vastus lateralis
(Anterolateral thigh)		 1 mL 25 gauge x 5/8 inch
Infant
2-12 mos		 1 mL 23 gauge x 1 inch
Toddler
1-3 yrs		 Deltoid if muscle
mass adequate		 1 mL 25 gauge x 5/8 inch
Vastus lateralis
(Anterolateral thigh)		 2 mL 23 gauge x 1 inch
Children
3-10 yrs		 Deltoid if muscle
mass adequate		 1 mL 25 gauge x 5/8 inch or
23 gauge x 1 inch
Vastus Lateralis
(Anterolateral thigh)		 3 mL 23 gauge x 1 inch