Prehospital tetanus shot

[ptemt]

Mosby's third edition revised paramedic text seems to suggest that some ems systems have tetanus shots in their protocol. Mine does not, does your's? Please post yes or no and where you are located if the answer is yes before delving into any controversy.

Thanks

[chbare]

Not here, perhaps it is a helpful idea to help keep immunizations current. Not all that helpful for people with tetanus prone wounds. The immunization will take up to a couple of weeks before immunity occurs. A TIG would be needed in these patients.

Take care,

chbare.

[FormerEMSLT297]

MD, Nope, DC, Nope, VA Nope

[spenac]

Mosby's third edition revised paramedic text seems to suggest that some ems systems have tetanus shots in their protocol. Mine does not, does your's? Please post yes or no and where you are located if the answer is yes before delving into any controversy.

Thanks

I think it means that the paramedics should have current tetanus shots. No reason in the field to give them to people.

[VentMedic]

The closest thing we had in Florida was a couple of county agencies attempted to do community service clinics which included immunizations. That was not widely welcomed by the Paramedics.

There may also be protocols for disaster type situations where the paramedics can become part of a public health effort and help immunize against infections. I know we revised ours after Hurricane Andrew.

[ptemt]

I think it means that the paramedics should have current tetanus shots. No reason in the field to give them to people.

page 554

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Critical Thinking

Why is it crucial for you to be knowledgeable about and to ask the patient about tetanus vaccination if the vaccine is not carried on your ambulance?

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It just got me wondering if anyone has it in their protocol.

[Doczilla]

In Ohio, EMS personnel may administer vaccines in a declared emergency but not under routine operations. The particular vaccines are intentionally not specified, so the disaster plan may remain flexible.

'zilla

[spenac]

Wow. I just looked second edition page 589 says same thing. Never heard of ambulance carrying it. I could see in disaster but for everyday use.

Hey Docs help explain.

Maybe just a bad question never corrected?

[Ridryder 911]

I believe the intent was to "think" outside the box. I personally never heard or recommend Tetanus injections in the field as routine care. Again, hopefully to educate and expand on wound care and the possible illnesses associated.

R/r 911

[Dustdevil]

Yeah, my only experience in this is with mass-cas or disaster scenarios. At most airliner disasters I have been to (quite a few), an immunisation station is set up to give a HyperTet to all rescue and recovery workers. That's how I used to keep track of my last tetanus shot, by recalling the last airline crash I was at, lol.

Now, in the trauma ER, it is standard protocol to administer Tet to all trauma victims. I guess in a rural scenario, where you have a lot of time on your hands, twiddling your thumbs, wating for a bird or a LONG trip to a hospital, you might find an MD who wants that done. I have never encountered it though, and a great deal of my career has been spent in the rural setting.

It wouldn't be a bad thing at all. But it does seem a bit of a pointless thing. Not many times you're going to actually have a chance to do it, because you're generally going to be pretty busy with those patients anyhow.