Tetanus

Question 1

Which type of wounds are considered ‘tetanus-prone’?

Answer 1

Puncture injuries in contaminated environment e.g. gardening injuries
Wounds containing foreign bodies
Compound fractures
Wounds or burns with systemic sepsis
Certain animal bites/scratches

Question 2

Which type of wounds are considered ‘high-risk tetanus-prone’?

Answer 2

Any of the ‘tetanus-prone’ wounds with either:

• heavy contamination with soil, manure
• wounds or burns with extensive devitalised tissue
• wounds or burns requiring surgical intervention that is delayed for > 6 hours

Question 3

What is the full UK schedule for tetanus vaccination?

Answer 3

5 doses at appropriate intervals

Question 4

What is considered an adequate priming course for tetanus vaccination?

Answer 4

3 doses

Question 5

Which groups of patients would not require any immediate tetanus treatment following any type of wound?

Answer 5

Children/adults up to date with tetanus vaccines

Last dose must be within 10 years

Question 6

What should be done regarding tetanus protection in patients who’s last dose of vaccine was over 10 years ago, or in children aged 5-10 who haven’t had their pre-school booster?

Answer 6

Clean would –> none required
Tetanus prone wound –> immediate does of vaccine
High risk tetanus prone wound –> immediate does of vaccine + one dose human tetanus Ig

Question 7

What should be done regarding tetanus protection for patients who have not received an adequate priming course of vaccine?

Answer 7

Clean wound –> immediate dose of vaccine

Tetanus prone wound –> immediate dose of vaccine + one dose human tetanus Ig