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'Test A&E patients for tetanus', say researchers


Two-thirds of patients who present at accident and emergency with wounds have immunity to tetanus, according to a study by the Royal Liverpool University Hospital.

Writing online in the Emergency Medicine Journal, the authors suggest that testing all patients for immunity would be more cost-effective that giving unnecessary vaccinations.

They tested 200 patients presenting to A&E with wounds, finding that 68% tested positive for tetanus immunity and 32% negative.  

The authors said: “Testing all 200 and treating appropriately would save £984, or £4.92 per patient, compared with vaccination based on recall.

“On clinical grounds testing is advisable and it may produce significant cost savings.”


Readers' comments (4)

  • 1 is unable to look at this in isolation. In my ex area, most patients were from overseas, many had no Gp for follow up vaccinations, and cards to inform of them of their next vaccination were not available.
    There are very few reporeted cases of tetanus per annum, onn e needs to look at age- over 50 in the uk, country of origin and mechanism, i am not sure yet how some injuries from a clean mechanism makes one vulnerable to tetanus and this shoud also should be taken into consideration to save costs. i brought this to the attention of clinical leads on cost saving issues but have been informed that it is quicker and cheaper to do the vaccination.

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  • I was under the impression that anybody presenting with a wound would be given a booster. is this no longer the practice?

    I sincerely hope that cost is not the reason for withholding it where it is needed!

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  • Routine giving of tetanus boosters should not have been common practice since the new guidelines were issued in 2002. They state that a full course and 2 subsequent boosters, (which is the infant injections, pre-school booster and the teenage booster, so anyone up to around the age of 55 years who has had all childhood vaccinations) provides lifetime immunity against tetanus, unless it is a particularly tetanus prone wound, in which case it is not a booster that is required but tetanus immunoglobulin.

    Why has this been so difficult for people to understand and be adopted! We are still giving completetly unecessary boosters on a regular basis!

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  • Anonymous | 22-Jun-2012 2:46 pm

    from Anonymous | 22-Jun-2012 12:31 pm

    thanks for the update.

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