Prevention of tetanus in emergency and first aid services. Technical and organizational criteria

: The Authors emphasize the measures to be taken for tetanus prevention in an individually wounded patient. They have to be decided on the basis of: 1) A knowledge and understanding of the pathological process of tetanus; 2) The mode of action and limitations of the various preventive measures available; 3) The nature of the patient's wound; 4) The patient's history of tetanus immunization. The recommendations should therefore be regarded not as a set of hard and fast rules but as guidelines since, as with any scheme of general guidance on medical practice, they will not invariably cover the circumstances of all individual patients. In tetanus prevention it is of basic importance to establish and maintain active immunity by means of combined vaccines. Nevertheless, with availability of human tetanus immunoglobulins severe immunological reactions as anaphylactic shock are extremely unlike to occur. So that their use can be recommended in patients with tetanus prone wounds, who have not previously been given tetanus toxoid.