ED Decision Tools
Tetanus PEP
Decides whether a wound needs a tetanus booster, immune globulin, both, or neither — from wound type and vaccination history (CDC/ACIP).
Clean wound or dirty wound?
Dirty (Tetanus-Prone) WoundsPuncture wounds · Crush injuries · Burns · Frostbite · Avulsions
Contaminated with soil, dirt, feces, or saliva
Devitalized or necrotic tissue · Wounds >6 hours old
Missile injuries (gunshot, shrapnel)
Contaminated with soil, dirt, feces, or saliva
Devitalized or necrotic tissue · Wounds >6 hours old
Missile injuries (gunshot, shrapnel)