Tetanus prophylaxis: Difference between revisions
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Incubation Period: | ==Background== | ||
* Tetanus immunoglobulin (TIG) and the tetanus vaccine (Td) are both crucial in preventing symptomatic tetanus infection | |||
*Incubation Period for a tetanus infection: 1day - 2 months | |||
*70% of wounds are prone to tetanus. These include contaminated wounds or puncture wounds but 30% are clean wounds. There are also case reports of surgically created wounds with autoclaved instruments resulting in tetanus <ref>CDC. Tetanus surveillance – United States. 2001-2008. MMWR 2011,60(No. 12) [http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6012a1.htm Fulltext]</ref> | |||
==Prophylaxis== | |||
[[File:Tetanus.png|thumb|An Algorithm for Tetanus Prophylaxis in Adults <ref>Diphtheria, tetanus, and pertussis: recommendations for vaccine use and other preventive measures. Recommendations of the Immunization Practices Advisory committee (ACIP). MMWR Recomm Rep. 1991;40(RR-10):1-28.</ref>]] | |||
*Past vac unknown or <3 total | |||
**Clean wound → Td | |||
**Dirty wound → Td & TIG | |||
*Past vac 3 or more total | |||
**Clean wound → Td Q10yrs | |||
**Dirty wound → Td Q5yrs | |||
{{Tdap chart}} | |||
==See Also== | ==See Also== | ||
*[[Tdap (Pertussis Vaccine)]] for new recommendations from CDC | |||
*[[Tetanus (Acute)]] | |||
==References== | |||
<references/> | |||
[[Category:ID]] | [[Category:ID]] | ||
[[Category:Trauma]] | |||
Revision as of 19:13, 21 December 2020
Background
- Tetanus immunoglobulin (TIG) and the tetanus vaccine (Td) are both crucial in preventing symptomatic tetanus infection
- Incubation Period for a tetanus infection: 1day - 2 months
- 70% of wounds are prone to tetanus. These include contaminated wounds or puncture wounds but 30% are clean wounds. There are also case reports of surgically created wounds with autoclaved instruments resulting in tetanus [1]
Prophylaxis
An Algorithm for Tetanus Prophylaxis in Adults [2]
- Past vac unknown or <3 total
- Clean wound → Td
- Dirty wound → Td & TIG
- Past vac 3 or more total
- Clean wound → Td Q10yrs
- Dirty wound → Td Q5yrs
Tetanus Vaccine Selection Guide
| Age | If No Pertussis Contraindications | If Pertussis Contraindicated | Comments |
| 2mo - 7yrs | DTaP | DT | DT available from pharmacy |
| 7yrs - 10yrs | Td | Td | |
| 10yrs | Tdap(Adacel)^ | Td | ^Off label use, but appears safe and immunogenic |
| 11yrs - 16yrs | Tdap(Adacel) | Td | |
| 16yrs - 65 | Tdap(Adacel)^^ | Td | ^^Use Td if patient is known to have received prior Tdap |
| 65yrs + | Td |
Td |
Consider TIG for tetanus prone wound plus Td(tetanus immune globulin) |
Caveats
- Adolescents who have already gotten a booster dose of Td are encouraged to get a dose of Tdap as well. Waiting 5 years after their last Td is encouraged but not required. A period of at least 2 years between Td and Tdap is recommended in these cases.
- Pregnancy is not a contraindication to Tdap. The only true contraindication to tetanus immunization is a history of neurologic or severe hypersensitivity to a previous dose.
- Stable neurologic disorders and family history of vaccine reactions are not contraindications to receiving these vaccines.
- No vaccine has ever been shown to play any role in the development of autism or autism spectrum disorders.
See Also
- Tdap (Pertussis Vaccine) for new recommendations from CDC
- Tetanus (Acute)