Published May 23, 2004
klone, MSN, RN
14,856 Posts
When a person comes into the ED with a wound, and a tetorifice shot is administered, do you give the tetorifice toxoid or the tetorifice immune globulin?
galenight, BSN, RN
193 Posts
In our facility if the person has not had a tetorifice in 5+ years we give a TD (tetorifice and diptheria). Rarely to we give the toxoid. A couple of docs will give the tetorifice immune globulin especially if the patients tetorifice status is unknown or very long or the method of injury is particularly suspicious for tetnus... ie rusty nail. When we give the immune globulin you must also give the TD. the immune globulin only provides temporary immunity until the TD can make the persons own immune system step up to the plate and protect on a more permanent basis.
In our facility if the person has not had a tetorifice in 5+ years we give a TD (tetorifice and diptheria). Rarely to we give the toxoid.
Thank you. What's the difference between the toxoid and the TD (other than the addition of D)? I thought all tetorifice immunizations were either toxoid or immune globulin?
the addition of the D is the only difference that I am aware off the top of my head.
Okay, then I'm confused when you said "rarely do we give the toxoid." Do you mean that you usually give the TIG?
erica110
3 Posts
I think she meant "rarely do we give the immune globulin". I too, work in the ER, and what was posted earlier is correct. Think of the "immune globulin" we give to pregnant women who are rh neg. Same idea here. The tetorifice immune globulin supplies the antibodies directly without your immune system having to create them on its own. For high risk groups (those never immunized) with a high risk exposure we give the tet.immune globul. AND the Td toxoid (0.5cc IM). The immune globulin gives immediate coverage until the td toxoid can stimulate the immune system to make it on its own. For the normal folk, we just give the Td toxoid.