Tetanus vaccination: The issue of ‘just in case’ vaccinations in emergency departments

SummaryThe Australian guidelines for tetanus prophylaxis are evidence based and freely available to clinicians. The literature suggests however that emergency department personnel often ignore these guidelines when assessing the need for tetanus vaccination for patients with injuries presenting to the department. Under and over vaccination are common errors, and a number of misconceptions about this practice have arisen. Some of the confusion stems from different recommendations implemented in varying developed countries, and the very small number of tetanus infections that occur. This paper will outline the primary immunisation, and tetanus prophylaxis guidelines that should be followed in Australian hospitals. Common errors, beliefs, and implications for nursing practice will be identified. A case presentation from the authors practice will begin the discussion.