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Mysteries of the Tetanus Shot

Rob Orman, MD and Ran Ran, MD
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Tetanus in developing nations still accounts for hundreds of thousands of death worldwide. Vaccination in the developed world has made tetanus extremely rare.  


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Seth B. -

As stated, in USA criteria is both dirty wound AND not receiving primary series. However, The CDC case series found that 12% of tetanus cases had completed their primary series but most of them were not up-to-date on their boosters. (3% of cases had received their primary series and were up-to-date on their boosters)
It wound seem to me that the US' criteria are insufficient?

Cameron E. -

I had an interesting dilemma regarding Tetanus Booster and TIG. An Amish male presented to the UC with a foreign body in the left lower extremity. He was on a construction site when he brushed up against unfinished wood and a large splinter went thru his denim pants and punctured his skin. States despite using pliers he was unable to remove the splinter and thereby came to the UC for help. I removed a 6cm wooden splinter without complication. However, in discussion, patient had never received any immunizations. Being that the case was after listening to this podcast I realized it would be best practice to provide TIG. Unfortunately, neither the UC nor the hospital had TIG. It was past 5p and health department was closed and uncertain if they even had it in stock. In fear of losing this patient to follow-up I worked with the hospital for a solution. Without divulging what was devised, I want to see what would others do in this situation?

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Mysteries of Tetanus & Influenza Full episode audio for MD edition 184:56 min - 87 MB - M4AHippo Urgent Care RAP January 2016 Summary 533 KB - PDF