An adolescent whose leg was crushed when she fell off a horse is admitted to the emergency department. She has completed the tetanus immunization series, receiving the last tetanus toxoid booster 8 years ago
What care is necessary for therapeutic management of this adolescent to prevent tetanus?
a. Tetanus toxoid booster is needed because of the type of injury.
b. Human tetanus immunoglobulin is indicated for immediate prophylaxis.
c. Concurrent administration of both tetanus immunoglobulin and tetanus antitoxin is needed.
d. No additional tetanus prophylaxis is indicated. The tetanus toxoid booster is protective for 10 years.
ANS: A
Protective levels of antibody are maintained for at least 10 years. Children with serious "tetanus-prone" wounds, including contaminated, crush, puncture, or burn wounds, should receive a tetanus toxoid booster prophylactically as soon as possible. This adolescent has circulating antibodies. The immunoglobulin is not indicated.
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