It begs the question "should we be providing active immunisation in A&E?".
Clearly we need to passively immunise with the immunoglobulin if the patient
isn't immunised and has a tetanus prone wound - we just take the opportunity
of actively immunising with toxoid if they need it. Strictly speaking
that's a primary care duty - until now I've been happy to provide it to
avoid inconveniencing the patient who, after all, doesn't understand our
lines of responsibilty and would feel messed about if I sent them to their
GP to update their tetanus - probably wouldn't go anyway. This will make me
reconsider - my job's nothing to do with immunisation against diptheria -
where does it stop? - do we end up entering into the MMR debate??
Nick Jenkins
A&E Consultant, Abergavenny
http://www.ae-nevillhall.org.uk
-----Original Message-----
From: Rowley Cottingham [mailto:[log in to unmask]]
Sent: 12 May 2002 9:37 AM
To: [log in to unmask]
Subject: Re: Replacement of tetanus booster for adults
As with so many of these vaccination issues, there is a strong whiff of
political correctness. Diphtheria is endemic in the Baltic states, and there
have been large numbers of visitors arriving from there. I suspect that the
decision was made to change it for everyone. It's a bit like MMR; the
people most at risk of serious attacks or complications of these childhood
exanthema are the Afro-Caribbean and Asian immigrant population.
Best wishes,
Rowley Cottingham
[log in to unmask]
http://www.emergencyunit.com
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