DrAlex_76
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A 25 yo man, come to ER after cycling accident. He has dirty deep abrasions over the left thigh, shoulder, and forearm. His last tetanus shot booster was 7 years ago. The wounds are debrided, cleaned, dressed. Which one of the following is recommened before discharge from the ER ?
A. tetanus shot
B. Tetanus -diptheria booster
C. Tetanus booster
D. DTP
E. tetanus Ig
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| hope4dabest
Forum Elite
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E....
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| DrAlex_76
Forum Senior
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come on people ...
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| hero
Forum Guru
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incomplete list of choices
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| arlete
Intern in 2009!!!!!
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C + E
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| usmletopper2
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We should ask about is previous vaccination history,if all child hood vaccinations are completed as it is a dirty wound and previous vaccine history more than 5 yrs Td booster+no need of Tig
if all childhood vaccines are not taken(less than 3) as it is a dirty wound -Td+TiG
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| peter90036
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| GOGETA
I'm Dr. GOGETA
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A because booster is every 10 years
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| GOGETA
I'm Dr. GOGETA
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so what is the answer?
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As a general rule, the better it felt when you said it, the more trouble it's going to get you into.
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| mildus
Forum Guru
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I would say C (just tetanus booster dose).
However, if it had passed more than 10 yrs from vaccination or if he hadn't been vaccinated completely or if we didn't have data about his vaccination (preferably written data), we would have given him both Ig and vaccine
Edited by mildus on 06/12/08 - 02:35 PM
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| peter90036
Forum Elite
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Wound management (CDC.GOV)
....fix the forum software...
Edited by peter90036 on 06/12/08 - 02:54 PM
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| arlete
Intern in 2009!!!!!
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OK. Then, for every patient that for sure received complete immunization, no matter when, we will NEVER use Ig, is that right? (Just trying to memorize it).
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| hero
Forum Guru
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It's Dtap (preffered according to guidance) +TIg (dirty wound)
Question is incomplete, but recognizable from KQB
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| peter90036
Forum Elite
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how incomplete is it, because it says Tet booster was admin 7y ago = DTAP was finished and now just getting booster shots q 10y...(as understandable by given Q txt)
and Ig is only given if unknown/incomplete vaccination.
here's more guidelines
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| hero
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bcs the last tetanus known, but prior h/o vaccination unknown, nothing abt complete childhood vaccinations sayed, fits in "dirty wound, unknown or <3 doses"
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| Vietnamese
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A- Tetanus shot
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| DrAlex_76
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Guess firstly, u should clearly understand what tetanus booster and tetanus shot are ?How they different ?
Guideline shows that when u got dirty wound and it has been more than 5 years since your last booster, u should have another booster shot.
Answer is C.
This is the complete question.
Thanks peter for the guideline.
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| dr_puma
Forum Senior
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Ig is used only in two scenarios-----3 dose schedule of tt not completed
-----status unknown
easier to rember like this
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