Tetanus Vaccine IM - into injured or non-injured limb?

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A farmer I was treating posed this question the other day, whilst I was giving him IM Tetorifice Ig into the deltoid of his his non injured limb.

He questioned why I was using the non injured side, as traditionally in farming he had been taught to inject vaccines etc etc into the injured side.

My rationale explanation was around the circulatory compromise due to swelling and localised inflammatory response on the injured side that could cause inadequate perfusion of the vaccine.

Is my rationale wrong? Discussion please from fellow nurses!!

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I read somewhere ???? similar rationale for using right vs left arm/hand for IV's in patients with mild/moderate weakness in one extremity, the blood flow is better in the "normal" arm. But it wasn't, isn't, a serious no no, or I assume it would be common knowledge? I mentioned it to an anesthesiologist, after I had started an IV, and he had never heard of it.

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Specializes in Emergency, Telemetry, Transplant.

I don't see any reason that a tetorifice shot would have to go into the injured arm. The only time I know that something has to be injected in the area of an injury is the injection of IG near an animal bite with concern for rabies--but this is not a vaccination.

Whether or not I injected it into the injured arm is based on what the injury is and where along the arm said injury is.

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Specializes in Adult and pediatric emergency and critical care.

I typically give injections in the arm a patient injured, they are going to be sore regardless and why make both arms sore if it can be just one? That being said I also give patients the option and it doesn't really make a big difference

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I typically give injections in the arm a patient injured, they are going to be sore regardless and why make both arms sore if it can be just one? That being said I also give patients the option and it doesn't really make a big difference

Me too. For the same reason.

Every once in awhile someone's really freaked out by the idea of being poked on the injured side (not so much once the local takes effect and they aren't experiencing pain any more).

I'm sure my lack of EBP here should bring great shame upon me. Alas, I do it this way because it makes good sense to me and I can't find anything that says it matters.

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Specializes in Critical care.

I'm so happy I was with-it enough to tell the ED nurse and doc I didn't need a tetorifice shot since it hadn't even been a year since my last one (I make sure I keep up on those). There's no way I would have let them anywhere near my injured arm with a tetorifice shot and I really would not have wanted my good arm hurting (my injured arm was totally useless and out of commission). Plus, not sure what happened with my last tetorifice shot, but I had a massive hard, red, hot, itchy, knot on my arm where I got the shot. Haven't had that happen with any other vaccine and I definitely was not that with-it to remember that. My thoughts would be the same as the OP though- use the good area that's not injured and inflamed.

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