Clinician awareness of tetanus-diphtheria vaccination in trauma patients: a questionnaire study

Abstract

BackgroundMost trauma patients visit the hospital via the emergency department. They are at high risk for tetanus infection because many trauma patients are wounded. Tetanus immunity in the Korean population has been revealed to be decreased in age groups over 20 years old. It is important for emergency physicians to vaccinate patients with the tetanus booster in wound management.MethodsQuestionnaires were sent to the directors of the emergency departments of resident training hospitals certified by the Korean Society of Emergency Medicine.ResultsTwo thirds of the emergency department directors surveyed reported applying tetanus prophylaxis guidelines to more than 80% of wounded patients. However, about 45% of clinicians in the emergency departments considered giving less than half of the wounded patient tetanus booster vaccinations, and there were no distinct differences in tetanus booster vaccination rates among different age groups. Most emergency physicians are familiar with tetanus prophylaxis guidelines for wound management. However, more than half of the emergency department directors reported that the major reason for not considering tetanus-diphtheria vaccination was due to assumptions that patients already had tetanus immunity.ConclusionAttitude changes should be encouraged among emergency physicians regarding tetanus prophylaxis. As emergency physicians are frequently confronted with patients that are at a high risk for tetanus infection in emergency situations, they need to be more informed regarding tetanus immunity epidemiology and encouraged to administer tetanus booster vaccines.

The use of tetanus post-exposure prophylaxis guidelines by general practitioners and emergency departments in the Netherlands: a cross-sectional questionnaire study

“…Individual adherence of these guidelines was not examined. Previous research in other countries showed that compliance to T-PEP guidelines was poor [ 15 , 23 , 24 ]. One difficulty of adhering to the T-PEP guidelines is obtaining a patient’s appropriate vaccination history [ 13 ].…”

“…Finally, this study only examined whether health care facilities had adopted guidelines as well as which guidelines had been adopted. Compliance with the guidelines at these facilities was not studied; research in other countries suggests that actual adherence to T-PEP guidelines is poor [ 15 , 23 , 24 ].…”

Clinical outcomes and healthcare costs of inpatients with tetanus in Korea, 2011–2019

“…According to the US Centers for Disease Control and Prevention, tetanus vaccines have largely contributed to the reduced tetanus surveillance and morbidity since 1990 [ 1 ]. Similarly, the incidence of tetanus in South Korea has decreased since the introduction of the diphtheria and tetanus toxoid and acellular pertussis vaccine in 1982 [ 2 ].…”

Practice and Knowledge Level of Health Professionals on Prevention of Tetanus

“…Unlike that, in a study by Yoon and his colleagues, 58.8% ofhealth care professionals stated that they do not apply vaccination as they think that injured patients have immunity for tetanus. 22 All these results suggest that health care professionals need to update their information about determination of immunization status of patients with acute injuries and establishment of appropriate immunization schedule according to wound classification. In our survey, 73.7% of participants had completed their childhood vaccination schedule; childhood immunization rates of physicians and nurses were 82% and 76% respectively.These rates were found to statistically significantly higher than non-health care professionals.…”