Anti-Tetanus Toxoid and Human Anti Tetanus Immunoglobulin guidance LWIC Practitioners will immunise patient according to both their immunisation status and the identification of a tetanus prone wound Immunisation Clean wound Tetanus prone wound status Vaccinated with Tetanus Toxoid Tetanus Toxoid Human Tetanus Immunoglobulin Fully Give if high risk i.e. immunised wounds or burns that • Patient has require surgical received a total Not required intervention and when of five doses of treatment is delayed for vaccine at more than six hours. appropriate wounds or burns that • intervals show any of the following characteristics: a Primary immunisation significant degree of devitalized tissue, complete, puncture-type injury boosters particularly in contact incomplete None required (unless next dose with soil or manure but up to date due soon and convenient to give now) wounds containing • foreign bodies compound fractures • wounds or burns in • patients who have systemic sepsis. Primary A reinforcing dose of vaccine and Yes: one dose of human immunisation further tetanus immunoglobulin incomplete or doses as required to complete the in a different site boosters not up recommended schedule (to to date ensure future immunity) Not immunised An immediate dose of vaccine or immunisation followed, if records confirm this is status not needed, by completion of a full known or course to uncertain ensure future immunity
Anti-Tetanus Toxoid and Human Anti Tetanus Immunoglobulin guidance LWIC Practitioners will immunise patient according to both their immunisation status and the identification of a tetanus prone wound Immunisation status Clean wound Vaccinated with Tetanus Toxoid Tetanus prone wound Tetanus Toxoid Immunoglobulin Human Tetanus Fully immunised Patient has received a total of five doses of vaccine at appropriate intervals Not required Give if high risk i.e. • wounds or burns that require surgical intervention and when treatment is delayed for more than six hours. • wounds or burns that show any of the following characteristics: a significant degree of devitalized tissue, puncture-type injury particularly in contact with soil or manure • wounds containing foreign bodies • compound fractures • wounds or burns in patients who have systemic sepsis. Primary immunisation complete, boosters incomplete but up to date None required (unless next dose due soon and convenient to give now) Primary immunisation incomplete or boosters not up to date A reinforcing dose of vaccine and further doses as required to complete the recommended schedule (to ensure future immunity) Yes: one dose of human tetanus immunoglobulin in a different site Not immunised or immunisation status not known or uncertain An immediate dose of vaccine followed, if records confirm this is needed, by completion of a full course to ensure future immunity