Emergency Medicine CME/CE

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test your knowledge

A farm worker presents with a contaminated crush injury to his lower leg. On examination, an open tibial fracture with obvious soil contamination is noted; the patient is hemodynamically stable. His tetanus vaccination history is unknown. The wound is copiously irrigated and the patient is referred for operative treatment of his fracture. Which of the following additional treatments is indicated?

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One dose of Td and follow-up with primary care
One dose of Tdap
Tdap with tetatnus immune globulin
None of the above (this is a low-isk injury and there is no need for tetanus prophylaxis)

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