Prophylaxis against tetanus should be considered in the management of wounds and other injuries.
|
Type of Wound |
History of Tetanus Immunization |
Tetanus-Diphtheroid Toxoid |
Tetanus Immune Globulin |
|
clean, minor wound |
not known |
Yes |
No |
|
|
< 3 doses |
Yes |
No |
|
|
>= 3 doses, last dose within 5 years |
No |
No |
|
|
>= 3 doses, last dose 5-10 years ago |
No |
No |
|
|
>= 3 doses, last dose > 10 years ago |
Yes |
No |
|
all other wounds |
not known |
Yes |
Yes |
|
|
< 3 doses |
Yes |
Yes |
|
|
>= 3 doses, last dose within 5 years |
No |
No |
|
|
>= 3 doses, last dose 5-10 years ago |
Yes |
No |
|
|
>= 3 doses, last dose > 10 years ago |
Yes |
No |
"All other wounds" may include:
(1) wounds contaminated with dirt, soil or feces
(2) wounds contaminated with saliva
(3) puncture wounds
(4) avulsion wounds
(5) burns
(6) crush injuries
(7) frostbite
(8) wounds with a missile (arrow, bullet, etc.)
Toxoid Preparations:
(1) for children under 7 years of age, DTP (diphtheria-tetanus-pertussis) is preferred; if pertussis vaccine is contraindicated, administer DT (diphtheria-tetanus)
(2) for children 7 years and older, and for adults, Td (tetanus diphtheria toxoid, adult type) is given
Dosages and Administration:
(1) absorbed toxoid: 0.5 mL
(2) tetanus immune globulin: at least 250 units
(3) if both toxoid and immune globulin are given, they should be injected with different needles and syringes into anatomically distant sites
Specialty: Infectious Diseases, Pharmacology, clinical, Surgery, general, Surgery, orthopedic
