Analysis of appropriate tetanus prophylaxis in an Emergency Department

Ulus Travma Acil Cerrahi Derg. 2013 Jul;19(4):320-6. doi: 10.5505/tjtes.2013.05014.

Abstract

Background: In this study, our aim was to identify the validity of the prophylaxis indications for patients who received tetanus prophylaxis, determine the ratio of high-risk wounds to the number of patients with immunity, and to evaluate the tetanus immunity of specific age groups.

Methods: Patients who applied to the Emergency Department (ED) between September 2009 and May 2010 and who were considered for tetanus prophylaxis by his/her primary care physician were included in the study.

Results: A total of 320 patients were evaluated. The average age of the patients was 40.87 ± 15.83 years. A total of 73.1% of the patients were male and 26.8% were female. A total of 40.3% of the patients knew their vaccination history, while 59.7% had no recollection of their vaccination history. 14.7% of the patients had received their last dose within 5 years and 48.1% within 5-10 years; 37.2% of the patients declared that more 10 years had passed since their last vaccination. In 75% of the patients, the tetanus immunoglobulin (Ig)G level was identified as >=0.1 IU/ml, while 25% of the patients had levels <0.1 IU/ml. The number of patients with protective levels was lower among those who were illiterate or who had only a primary school education, and this difference was statistically significant (p<0.001).

Conclusion: The vaccination histories can be misleading. Certain equipment can be used at the bedside to determine a patient's tetanus immunization status.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Educational Status
  • Emergency Service, Hospital
  • Female
  • Humans
  • Male
  • Middle Aged
  • Tetanus / immunology
  • Tetanus / prevention & control*
  • Tetanus Toxoid / administration & dosage*
  • Vaccination
  • Wounds and Injuries / immunology
  • Wounds and Injuries / microbiology*
  • Wounds and Injuries / therapy
  • Young Adult

Substances

  • Tetanus Toxoid