Background: Have you ever seen a case of tetanus? Don't feel bad if you haven't - there were only four in the whole of England during 2016. The disease is admittedly terrible: the muscle spasms can be so severe they cause fractures, and serious complications loss of airway and respiratory arrest. Thankfully, vaccination has made the condition extremely rare in the developed world. But it often feels as though confusion reigns over the best approach to vaccination in the ED... Who needs a booster? Who needs immunoglobulin? What kind of patient? What kind of wound? The Department of Health recently updated their guidance on tetanus immunisation, replacing the 2013 recommendations. Here is the bite-sized BREACH summary of the document...

 

 

Department of Health (2018). Tetanus: The Green Book, chapter 30

 

See www.the-breach.com for summary tables