Tetanus Risk and First Aid after a Fire
Tetanus Risk after a Fire
After a wildfire, there is risk of injury as cleanup efforts begin. Tetanus is a concern for persons with both open and closed wounds, and a tetanus vaccination is recommended for all residents returning to the burn area who have not had a documented dose within the past ten years. Prompt first aid management for wounds and prevention of infection is another important consideration.
If you receive a puncture wound or a wound contaminated with feces, soil, or saliva, a health care professional should determine if a tetanus booster is necessary, based on individual records.
Tetanus Prevention
- Patients without a clear history of receiving at least three tetanus vaccinations and who have any wound should get the tetanus immune globulin (TIG) as well as the tetanus vaccination.
- Tetanus in the United States is most commonly reported in people older than 40 because they are less likely to be adequately vaccinated.
- Women over 55 years of age are especially susceptible because they likely do not have protective levels of tetanus antibody.
- Diabetics are at increased risk for tetanus. Reported tetanus is about three times more common in diabetics, and fatalities are about four times more common.
- Non-acute wounds account for about 1 in 6 cases of reported tetanus; 1 in 12 reported cases had no reported injury or lesion.
Wound Protocol
Vaccination History | Clean, Minor Wounds | All Other Wounds |
Unknown or less than 3 doses | Td or Tdap | Td or Tdap PLUS tetanus immune globulin (TIG) |
3 or more doses and less than 5 years since last dose | ||
3 or more doses and 6-10 years since last dose | Td or Tdap | |
3 or more doses and more than 10 years since last dose | Td or Tdap | Td or Tdap |
Wound Care
Seek medical attention as soon as possible if:
- There is a foreign object embedded in the wound.
- The wound is at special risk of infection (such as a dog bite or a puncture by a dirty object).
- A previous wound shows signs of becoming infected (e.g. increased pain and soreness, swelling, redness, draining, or you develop a fever).
Care for Minor Wounds
- Wash your hands thoroughly with soap and clean water.
- Avoid touching the wound with your fingers while treating it.
- Remove obstructive jewelry and clothing from the injured area.
- Apply direct pressure to any bleeding wound to control bleeding.
- Clean the wound after bleeding has stopped:
- Examine wounds for dirt and foreign objects.
- Gently flood the wound with clean water.
- Gently clean around the wound with soap and clean water.
- Pat the wound dry and apply an adhesive bandage or dry clean cloth.
- Provide pain relievers, if possible.
Other Considerations
- Wounds in contact with soil and sand can become infected.
- Puncture wounds can carry bits of clothing and dirt into wounds and result in infection.
- Crush injuries are more likely to become infected than wounds from cuts.