How to administer an injection if the tetanus skin test is negative

Written by Xu Jun Hui

General Surgery

Updated on December 10, 2024

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A negative tetanus skin test indicates that there is no allergy to tetanus antitoxin, and 1500 to 3000 units of tetanus antitoxin can be directly administered via intramuscular injection in the upper arm or buttock. If the wound is heavily contaminated or the injection is not timely, the dose may be doubled or tripled at discretion, and it is also necessary to clean and dress the wound. The purpose of administering tetanus antitoxin via intramuscular injection is to prevent infection by Clostridium tetani. Therefore, patients with heavily contaminated or deep wounds must receive tetanus antitoxin treatment.

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What will happen with tetanus?

Firstly, it should be noted that tetanus is a curable specific infection. Typically, after being infected with tetanus, the early symptoms mainly include dizziness, headache, fatigue, decreased appetite, refusal of weakness, jaw pain, or some hyperreflexia. As the condition worsens, symptoms such as muscle spasms, muscle rigidity, risus sardonicus, difficulty opening the mouth, lockjaw, opisthotonos, and stiffness in the neck can occur. In severe cases, there may be difficulty breathing, respiratory arrest, and even cardiac arrest. The vast majority of tetanus patients can fully recover through proper and systematic treatment.

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What are the complications of tetanus?

The main complications of tetanus primarily include suffocation, atelectasis, and pulmonary infections. Patients with severe conditions should have a tracheotomy performed as soon as possible to improve ventilation and clear the respiratory tract secretions. At the same time, artificial assisted breathing can be conducted, and hyperbaric oxygen therapy can be used as an adjunctive treatment. Care during tracheotomy should focus on airway management, including airway nebulization, humidification, flushing, and prevention of pressure sores, utilizing strict aseptic techniques to prevent cross-infection and subsequent pulmonary infections. Antibiotics should be selected based on the type of bacteria, and dedicated personnel should be assigned for nursing to prevent injuries from biting the tongue.

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How long does the tetanus shot last?

The duration of the effectiveness of a tetanus shot depends on whether tetanus antitoxin or tetanus immunoglobulin is administered following a suspected tetanus infection. Both types are forms of artificial passive immunity, providing immediate specific immunity after injection, mainly for treatment or emergency prevention. The metabolism and immune duration of these two injections vary: generally, tetanus antitoxin lasts about seven days, while tetanus immunoglobulin can last up to three weeks. Therefore, the specific duration of the effectiveness of a tetanus shot must be determined based on the individual injection circumstances. For suspected tetanus infections, it is generally advised to administer the injection as soon as possible. It's not that the injection will be ineffective if administered after a certain time, but rather that effective prevention before the onset of the disease can still be beneficial.

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How many times can a tetanus shot be administered in a year?

The tetanus toxin vaccine is used for emergency vaccination. The main ingredient of this vaccine is the tetanus antitoxin. It is best to be vaccinated within 24 hours, and the sooner the vaccination is administered, the stronger the potential for protection. However, the duration of protection provided by the vaccine is not very long, and the effect of the tetanus antitoxin medication generally lasts about a week. Therefore, vaccination within 24 hours can effectively prevent problems that may occur within that week. Generally, there is no specific number for the annual frequency, but it is usually recommended not to exceed three times per year. Of course, this depends on the degree of injury. If there is a risk of infection, then the vaccine should be administered since its preventive effect is currently considered the best and can achieve significant efficacy.

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Is tetanus fatal?

Tetanus infection is quite frightening, with current statistics showing that the mortality rate of tetanus infections can be as high as 40%, and about a million people die from tetanus globally each year. The current principle is to promptly inject tetanus antitoxin or tetanus immunoglobulin for sharp, deep wounds. For tetanus infection, the main symptoms manifest as local or systemic muscle rigidity and spasms. The incubation period varies; if a tetanus vaccination has been previously administered, or depending on the infection and treatment of the wound, the severity of the onset can differ. The prodromal period typically presents symptoms like dizziness, headache, heightened reflexes, restlessness, and possible difficulty opening the mouth; during the convulsive phase, there is continuous muscle contraction, eventually causing persistent spasms in the diaphragm and intercostal muscles.