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To not understand tetanus jab guidance?

(8 Posts)
mangomay Mon 29-May-17 14:40:42

DD was playing on the green with some friends, another child brought over a fence panel (don't ask) and managed to drop it on her foot. Nice puncture wound from a screw. Took her to minors and they cleaned and dressed it. Nurse said if she's up to date with imms she shouldn't need a tetanus jab, but NHS website says 5 doses are needed for full protection. DD is 10 so has only had 4. So I'm confused, should I take her back and ask for a booster or not?!

mangomay Mon 29-May-17 14:47:54

Gonna bump this because I'm impatient....
Anyone have any wisdom?

percythepenguin Mon 29-May-17 14:49:44

The five doses is for lung term immunity, she will be covered by the doses she has already had, see the guidance on the table below-

percythepenguin Mon 29-May-17 14:50:17

Oops long term and the table came out above...

DancingLedge Mon 29-May-17 14:51:38

My understanding is that 5 is regarded as done for life.( although more may be given if there's especial cause)
If you're not behind with any doses, during the course of 5, which takes place over several years,
you're protected.

I wouldn't have concern in your situation.

mangomay Mon 29-May-17 15:00:52

Thanks for that handy table, the NHS website isn't particularly clear and only says 5 doses gives full protection. It was a disgusting, rusty old nail but we flushed it with saline straight away and the nurse took a good look and couldnt see any dirt or debris. My next stress is that it still hasn't stopped bleeding (it happened at 10 this morning). DD said it was a nail, but it was actually a 6 inch screw, how it didn't go all the way through her foot I'll never know. Does anyone know how long it should take to stop?

Sidge Mon 29-May-17 15:47:23

She doesn't need any more tetanus doses until she's next due (around the age of 13-14).

The "old" advice was to have routine tetanus boosters every 10 years, so we'd get adults pitching up for their 10-yearly tetanus booster. The guidance now is that if you've had your primary course of 5 doses (3 as a baby, 1 preschool and 1 before leaving school) you have protection for life UNLESS you have a tetanus prone wound. This is a wound that is deep, devitalised and dirty, especially contaminated with soil or manure. Rust alone doesn't increase the risk of tetanus. If you have a tetanus prone wound you wouldn't give a DTP (diphtheria, tetanus and polio) vaccine, you'd give immunoglobulins.

When you say it was dressed, but still bleeding, what do you mean? Bleeding through a dressing? Try applying pressure and elevating her foot, it should stop.

mangomay Mon 29-May-17 18:50:32

Sidge thanks. I spoke to NHS 111 after reading into it a bit more, because the wound was very deep and prior to being dropped on DDs foot, the screw had been in the ground so had soil on as well as rust. They've advised GP tomorrow and he'll give a booster, but from what I read (and what you've just said) it would be a tetanus immunoglobulin injection. The woman I spoke to was a clinical advisor, not a HCP but she said the advice is it's ok to wait up to 48 hours after the injury. So now I'm still slightly confused, but will call GP in the morning just to be sure.
Yes dressed with an inadine dressing, mepore over that and a tubigrip over that and it has soaked through all 3. It's not bleeding heavily, just oozing but the whole mepore dressing needs changing now. Looks like it's starting to slow down, she took herself off to bed and has been watching tv/reading with it raised on a pillow since we got back.

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