- Discussion:
- goal is to avoid a life threatening
clostridium infection;
-
tetanus prone wounds:
- greater than 8-24 hrs from injury to treatment
- barnyard contamination (bite wounds are considered moderate risk);
- devitalized tissue;
-
prophylaxis:
- if pt is fully immunized in past but has not received booster for over 5 years, then should receive 0.5 ml of tetanus toxoid IM;
- pts who have not received full course of immunization should not only receive
tetanus toxoid but also should receive
passive immunization;
- consider 250 units of human tetanus immune globin IM;
- peds: 4 units/kg body wt;
-
treatment of tetanus:
- appropriate antibiotics and debridement;
- tetanus immunoglobin:
- 500-1000 units to a total dosage of 6000 to 10,000 units is given in second arm;
The effect of steroids for shock on the immune response to tetanus toxoid.
Tetanus and trauma: a review and recommendations.
