Adequacy of antitetanus prophylaxis in six hospital emergency rooms.
Publication/Presentation Date
9-15-1983
Abstract
We studied the adequacy of antitetanus prophylaxis given to 620 patients with open soft-tissue injuries by 169 physicians in six hospital emergency rooms. Twenty-three per cent of the patients were treated incorrectly (6 per cent were undertreated and 17 per cent were overtreated) with tetanus toxoid or human tetanus immunoglobulin. Undertreatment ranged from 4 to 11 per cent, and overtreatment from 5 to 38 per cent at the different hospitals (P less than 0.01). Patients at highest risk for tetanus (those with tetanus-prone wounds who had never been given a complete initial course of immunizations) had the lowest likelihood (27 per cent) of receiving correct antitetanus treatment. By following an immunization protocol based on time since injury, mechanism of injury, estimated bacterial contamination, presence of devitalized tissue, wound depth, and past immunizations, physicians can better protect the population against tetanus while lowering the risk of adverse drug reactions and not increasing the cost of care.
Volume
309
Issue
11
First Page
636
Last Page
640
ISSN
0028-4793
Published In/Presented At
Brand, D. A., Acampora, D., Gottlieb, L. D., Glancy, K. E., & Frazier, W. H. (1983). Adequacy of antitetanus prophylaxis in six hospital emergency rooms. The New England journal of medicine, 309(11), 636–640. https://doi.org/10.1056/NEJM198309153091104
Disciplines
Medicine and Health Sciences
PubMedID
6888430
Department(s)
Department of Surgery
Document Type
Article