14yrs old boy,One of your long term patient since birth,presents to you at your surgery after Dog bite at home,when he was playing with it , accidentally fell over the animal and provoked it. O/E There were Two deep puncture wounds. No deep structural injury.His last immunisation for tetanus was at 4 yrs of age according to his File.You advise him to get the wounds cleaned and apply non-Adherent , absorbent plaster by the Office nurse and give him prophylactic antibiotics for 5 days. As the bytes are deep puncture wounds you decided to give him tetanus injections as well.Which one is the BEST vaccination?.
1.DTPa(Diptheria,Tetanus,Pertussis acellular) written as dTpa
- Tetanus Toxiod-Tetanus toxoid should be administered if 5 years since the last dose and the patient has completed a full primary course of tetanus immunisation
3Adult Tetanus and Diptheria Toxoid
4.Tetanus immunoglobulin + Tetanus toxoid-in unvaccinated
5.Diptheria toxoid +whole cell pertussis +Tetanus toxoid (DPT) booster.
As dog bites are considered as contaminated and this boy less than 20 years incomplete tetunus vaccations the answer should be 4 such as immunoglobulin and tetunus toxoid should follow.
Might need catchup vaccations later to compensate immunization schedule as here in this scenario they didnt mention the so called 4 yr vaccine details.
really OMG I mention as it is in your questions given so called answer options though it looks wierd.
Surely and definetly and honestly this 14 year child should be given a dose of dtpa and follow up with catchup schedules .in dTpa diptheria also in toxoid form unfortunately .whatsoever .