Tetanus Prophylaxis Decision Tree
Tetanus Prophylaxis Decision Tree - a deterministic tool in Sophie Well's Immunization & Infectious Disease group.
Open the Tetanus Prophylaxis Decision Tree → Runs in your browser. No signup, no tracking.
What this is
Cross-reference the CDC's tetanus prophylaxis decision matrix: wound type (clean and minor vs. all other wounds) by immunization history (uncertain or fewer than three prior doses vs. three or more, and time since the last booster). The tile returns the recommended action - no vaccine, Td or Tdap booster, tetanus immune globulin (TIG), or both vaccine and TIG - and notes the CDC preference for Tdap when the patient has never received it, especially in pregnancy and household contacts of infants.
When to use it
Use this in any ED, urgent-care, or primary-care visit for a wound, burn, or animal bite, and at routine adult and pregnancy visits where booster status is being reviewed. The dirty-wound criteria - contamination with dirt, feces, saliva, or soil; puncture wounds; avulsions; crush, burn, frostbite, or missile injuries - matter because they expand the TIG indication. A clean minor wound in a patient with three prior doses and a booster within the last 10 years needs nothing; a dirty wound in an undervaccinated patient may need both Tdap and TIG.
References
CDC/ACIP tetanus prophylaxis. Havers FP, et al. Use of Tdap, Td, and tetanus toxoid: ACIP recommendations. MMWR Recomm Rep. 2020;69(3):1-44. Wound-management table (Td/Tdap and TIG by wound type and vaccination history).
Source: CDC tetanus prophylaxis decision aid
Sophie Well is a reference and educational tool. Not medical, legal, or financial advice. Does not replace clinician judgment, professional billing review, or legal counsel.