robin082006
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A 35-year old man received a deep laceration with old rusted barbed wire while he was walking in the field. He was taken to local hospital. On examination there is 6cm(2.3in) long laceration on lateral aspect of leg, contaminated with dirt and soil. The laceration is bleeding profusely. He received 3 doses of tetanus immunization, when he was 23. What is the most appropriate next step in this patient?
A. Clean the wound only
B. Administer tetanus toxoid
C. Administer tetanus immune globulin
D. Administer tetanus toxoid and immune globulin
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| sarika
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wound is dirty and no booster recieved after 10 yrs so i will go with D. Administer tetanus toxoid and immune globulin
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| MHP
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Here is the answer. Is just TT
Attached Files:
History of tetanus.doc (25 KB, 39 downloads)
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| Guptashutosh
Forum Elite
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acc to kaplan if pt has had tt > 5 yrs the he shd recieve tt along with tt Ig in case of dirty wqound like this...
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| MHP
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Guptashutosh
Did you see the attach? This info is from UW, I dont know if is true . What dou you think?
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| krsna
Forum Senior
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hey MHP i've seen the attc man..i think it says its only tt if the last dose was 5 yrs ago which is not true n this case...so i guess the ans wud be D
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| robin082006
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answer is B, i also thought D like most of you.
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| lecheah
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at first i also thought the ans is d
but i check out the protocol by cdc, MHP is right, tetanus toxoid is enough
http://www.cdc.gov/nip/ed/vpd2006/Slides/chap06-t... 1
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| fox
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I think its a pretty new concept. remember reading it somewhere that Ig not neccesary if immunised in the past, no matter how long back. Anyway thanks for the good question.
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| usmle12
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ITS base don no of immunizations recieved if u have 3 or more u are in differnet category than if u have less than 3.....so this person has 3 immunizatins now if he had minor non dirty wound then wel imminize with tt if time sisnce last booster was more than 10 years buit since he has dirty wound well immunize if time since last booster is more than 5...
tig would be given if he had lees than 3 and wound was dirty...
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| ashfaque
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B nice question Robbin
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