no contraindication to vaccinations. Parents were worried about the vaccine side effects. What
will you give?
a. Clean the wound and dress it
b. Give TT only
c. Give DPT only
d. Give DPT and tetanus Ig
e. Give complete DPT vaccine course
answer: D
she was playing in the garden, so the wound was likely exposed to soil matter, this makes it a high risk even if the cut was clean, she needs both the vaccine and Ig immediately
The following are considered tetanus-prone wounds:
Wounds / burns requiring surgical intervention that is delayed for > 6hours
Significant degree of devitalised tissue
Wounds where there has been contact with soil or manure
Puncture-type injury
Compound fractures
Wounds containing foreign bodies
Wounds / burns in patients with systemic sepsis
Tetanus Prophylaxis
- for both tetanus and diphtheria, a total of 5 doses of vaccine at the appropriate intervals are considered to give lifelong immunity.
- in individuals, who have received a full 5 course of tetanus vaccine, suffers a tetanus prone wound,
- No vaccine
- Immunglobulin
- in individuals who have completed their primary immunisation
course and who are up to date with their tetanus immunisation
schedule
- the same rationale applies
- for those people whose primary immunisation is unknown, incomplete or booster schedule is not up to date,
- Vaccine
- Immunglobulin
- for travellers to areas where medical attention may not be accessible should a tetanus prone injury occur and whose last dose of a tetanus containing vaccine was more than 10 years ago, a booster dose of Td/IPV should be given, even if the individual has received 5 doses of vaccine previously. This is a precautionary measure in case immunoglobulin is not available to the individual should a tetanus prone injury occur
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