Recommendations for tetanus prophylaxis are based on:

1. The condition of the wound, as related to its susceptibility to tetanus
2. The patient’s history of tetanus immunization

The wound classification table (Table 6–6) and immunization schedule that follow are from the American College of Surgeons Committee on Trauma Prophylaxis Against Tetanus in Wound Management.

Immunization Schedule (Tetanus)

Verify a history of tetanus immunization from medical records so that appropriate tetanus prophylaxis can be accomplished.

^* Td: Tetanus and diphtheria toxoids adsorbed (for adult use).

^† TIG: Tetanus immune globulin (human).

¹ For children younger than 7 years old, diptheria and tetanus toxoids and pertussis vaccine adsorbed (or diphtheria and tetanus toxoids adsorbed, if pertussis vaccine is contraindicated) is preferable to tetanus toxoid alone. For persond 7 years old and older, Td is preferable to tetanus toxoid alone.

² When administering TIG and Td concurrently, use separate syringes abd separate sites.

³ Yes, if wound is more than 24 hours old.

⁴ Yes, if more than 10 years since last dose.

⁵ Yes, if more than 5 years since last dose. (More frequent boosters are not needed and can accentuate side affects.)