What to know about ATS for tetanus

It contains antibodies intended to neutralise tetanus toxin that has not yet attached to nerves. Because traditional ATS may be derived from horse serum and can trigger allergic reactions, its use depends on local practice, availability and a clinician's assessment. Human tetanus immune globulin is used in many settings when passive protection is indicated.

An antitoxin supplies ready-made antibodies for immediate, temporary protection or treatment. A tetanus-containing vaccine teaches the immune system to build its own protection, which takes time and requires the recommended series and boosters. Receiving antitoxin does not replace vaccination when vaccination is due.

Tetanus develops when bacterial spores enter damaged tissue and produce a toxin that affects nerves and muscles. Risk assessment considers the wound's nature, contamination, time since injury, previous wound care and whether the vaccination record is complete and reliable. Rust itself is not the cause; the concern is contamination and tissue conditions that allow spores to grow.

Rinse the wound with clean running water, remove visible loose dirt if this can be done safely, control bleeding with gentle pressure and cover it with a clean dressing. Arrange clinical assessment for a deep puncture, crush injury, bite, burn, wound containing soil or manure, devitalised tissue, or any wound when your vaccination history is uncertain.

Bring any vaccination record and explain when and how the injury happened. The clinician can clean the wound properly and decide whether vaccination, passive antibodies, antibiotics for another wound infection or other treatment is appropriate. Do not inject or apply ATS yourself.

Get emergency care for jaw stiffness, painful muscle spasms, trouble swallowing, breathing difficulty or marked body rigidity after a wound. After receiving an antitoxin, seek immediate help for swelling of the lips or tongue, widespread hives, wheezing, faintness or breathing trouble. Increasing wound redness, warmth, swelling, pus, fever or worsening pain also needs prompt assessment.

Ask whether the recommendation is for anti-tetanus serum, human tetanus immune globulin, tetanus vaccination or a combination. Confirm what reaction monitoring is needed, how the wound should be cared for and when the next vaccine dose is due.