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tetanus boost timings.
JC

7 Posts

Posted:  09-Aug-2018 14:45
How long after a tetanus prone injury is sustained can/should you give Revaxis? If it's a couple of weeks or so, how quickly will tetanus symptoms be observed? We've had pts come in 2-3 weeks later.....
tiredandemotional

4357 Posts



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Posted:  09-Aug-2018 15:00
Hi,

Does this help? What vaccine history do you have? Are they fully vaccinated for tetanus?

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/728172/Recommendations_on_the_treatment_and_prophylaxis_of_tetanus_July2018.pdf

 

This is just my opinion and not an instruction. T&E x
JC

7 Posts

Posted:  09-Aug-2018 15:23
thanks, T&E. A&E seem not to give TIG anymore, and don't even give DTP, sending pt back to us. Even with 5 vacc, or no evidence, it's really timings at a later date. All seems a bit vague for anything other than a really obvious injury. Will give by default really.
tiredandemotional

4357 Posts



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Posted:  09-Aug-2018 15:36
I think very few wounds that we would see in primary care would need TIG, as the PHE paper explains.

If you follow that, and the GB, you can't go wrong. 

I have sometimes asked ED to explain their rationale to me, which has been helpful.

This is just my opinion and not an instruction. T&E x
notnets

254 Posts

Posted:  09-Aug-2018 22:00
Ive had 2 seperate patients attemd 2 different A&E dept last week and both were given TIG . One patient I had refered there as a cockerels spur gad punctured a ladies leg (approx 2” deep) and I felt it required TIG , and ED agreed,however the other patient presented directly to A&E with a dog bite to the hand?!?! This is the first time Ive known someone recieve it for a fog bite, according to PHE most puncture type injuries from domestic pets mainly containe saliva and therefore lower risk!?!

pracpip
karen.rudd

12032 Posts

Posted:  09-Aug-2018 23:23
Maybe not everyone is up to date with the new advice about tetanus immunoglobulin and prioritising limited supply?

It was updated in July as was tetanus prone wound classification in the document T&E posted earlier. Here is the link again

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/728172/Recommendations_on_the_treatment_and_prophylaxis_of_tetanus_July2018.pdf

Might be worth contacting your A/E and check what guidance or rationale they are using ?

Please be informed that the above is the opinion of the author and is in no way meant to be taken as instruction.karen
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