A 38-year-old man who has recently emigrated from eastern Europe presents to Emergency
Department one hour after sustaining a 4 cm laceration to the dorsum of his left hand. He works as a
builder and sustained the laceration after cutting into a cardboard box using a Stanley knife.
On examining the wound there is no sign of a foreign body or neurovascular deficit. He is referred to
Plastics for apposition of the wound.
You ask him about his tetanus vaccination status. He has ‘no idea’ but can remember getting some
vaccinations as a child.
What is the most appropriate action with respect to tetanus?
Requires human tetanus immunoglobulin + tetanus vaccine + complete vaccine course at a
later date
Requires tetanus vaccine + complete vaccine course at a later date
Requires human tetanus immunoglobulin
No action required
Requires tetanus vaccine + oral penicillin V prophylaxis for one week
This wound is not high risk for tetanus. The Greenbook would however recommend that we vaccinate
against tetanus in this situation. His immunisation status is unknown and it is therefore prudent to
reduce his risk of developing tetanus in future by ensuring he has a complete course of tetanus
vaccination