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Old 05-25-2012
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Question Tetanus Prophylaxis Question

A 31-year-old woman presents to the emergency department after sustaining a small laceration to her finger while gardening. She injured herself on one of her kitchen knives. She has been previously well and does not take any regular medications. Her last tetanus-diphtheria vaccination was at age 24. Physical examination reveals a 2-cm-long, 7-mm-deep clean laceration on the dorsum of the hand. In addition to proper wound care, what is the most appropriate management to prevent tetanus?

A. No further management required
B. Tetanus immune globulin
C. Tetanus immune globulin and tetanus toxoid primary series
D. Tetanus toxoid booster
E. Tetanus toxoid primary series

is this clean or dirty wound?
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Old 05-25-2012
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Wound clean + less than 10 yrs since last dose..
So i think no Rx Required..
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Old 05-25-2012
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no Rx
Dirty wound puncture wounds. projectile wounds. wounds containing foreign bodies, sites of active infection by other organisms, and wounds containing necrotic tissue.
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Old 05-25-2012
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Quote:
Originally Posted by tyagee View Post
A 31-year-old woman presents to the emergency department after sustaining a small laceration to her finger while gardening. She injured herself on one of her kitchen knives. She has been previously well and does not take any regular medications. Her last tetanus-diphtheria vaccination was at age 24. Physical examination reveals a 2-cm-long, 7-mm-deep clean laceration on the dorsum of the hand. In addition to proper wound care, what is the most appropriate management to prevent tetanus?

A. No further management required
B. Tetanus immune globulin
C. Tetanus immune globulin and tetanus toxoid primary series
D. Tetanus toxoid booster
E. Tetanus toxoid primary series

is this clean or dirty wound?
-clean wound.A.
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Old 05-25-2012
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Quote:
Originally Posted by tyagee View Post
A 31-year-old woman presents to the emergency department after sustaining a small laceration to her finger while gardening. She injured herself on one of her kitchen knives. She has been previously well and does not take any regular medications. Her last tetanus-diphtheria vaccination was at age 24. Physical examination reveals a 2-cm-long, 7-mm-deep clean laceration on the dorsum of the hand. In addition to proper wound care, what is the most appropriate management to prevent tetanus?

A. No further management required
B. Tetanus immune globulin
C. Tetanus immune globulin and tetanus toxoid primary series
D. Tetanus toxoid booster
E. Tetanus toxoid primary series

is this clean or dirty wound?
If someone experiences a deep or puncture wound, or a wound contaminated with dirt, an additional booster dose may be given if the last dose was more than five years ago. This could be a dose of Td or Tdap, depending on the person’s vaccination history.

Quote:
Class I: Clean
Class I clean wounds are nontraumatic wounds with no presenting inflammation. These wounds do not involve the respiratory, gastrointestinal and genitourinary tracts. Examples of a Class I clean wound include vascular and endocrine procedures, eye surgery and simple orthopedic procedures, surgical procedures involving the skin and exploratory laparotomies.

Class II: Clean-Contaminated
Any wound open for drainage or reopened to remove wires, pins or for other surgical reasons is considered a Class II contaminated-clean wound. Class II wounds comprise generally clean wounds with a higher potential for infection. Gastrointestinal, respiratory or genitourinary tract surgeries without significant spillage carry the Class II wound label, as well as thoracic procedures, ear surgeries, nose/oropharynx procedures and gynecologic procedures.
Class III: Contaminated
A foreign body, such as a bullet, knife blade, or tree branch, passing through a wound indicates a Class III contaminated wound. Class III wounds accommodate a range of causes, including surgeries where a major break in operative technique occurs, serious spillage from the gastrointestinal tract, admittance into the genitourinary or biliary tracts, surgeries where infected urine or bile is present, and incisions involving serious inflammations.
Class IV: Dirty-Infected
Class IV dirty-infected wounds include traumatic wounds from a dirty source or that receive delayed treatment; dirty or infected operative wounds; a wound that is exposed to fecal matter or pus; and wounds in which a foreign body, such as a bullet or knife blade, is embedded. These wounds often involve wound debridement to rid it of infected tissue and may feature abscesses and infection.
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