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Tetanus Prophylaxis — ABEM Board MCQ

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ModerateEmergency MedicineTetanus ProphylaxisABEM Board

A 29-year-old with a contaminated puncture wound and unknown tetanus vaccination history presents to the ED. What is the correct prophylaxis?

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Correct answer: D — Tdap plus tetanus immune globulin 250 units IM

For dirty/major wounds with unknown or incomplete primary series, give Tdap (or Td) and TIG 250 U. Tdap alone is inadequate; TIG alone lacks active immunization.

Reference: CDC/ACIP (2025): Clinical Guidance for Wound Management to Prevent Tetanus