How to administer tetanus skin test if it is negative?

Written by Xing Wen Jun
General Surgery
Updated on June 18, 2025
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For patients whose tetanus skin test is negative, it is advisable that they proceed with a simultaneous intramuscular injection, generally considering the injection of tetanus antitoxin. For those patients who test positive in the skin test, it is often considered that they may be allergic to tetanus antitoxin; thus, it is advised that they consider receiving an injection of tetanus immune globulin for active prevention, which is of significant importance for the prevention of tetanus. If a patient is injured by a rusty iron object, and the wound is small and deep, it is recommended that the patient first cleans the wound under running water and repeatedly washes it with soap water, then wipes and applies peroxide with a gauze. Subsequently, dress the wound with sterile dressings, and consider applying iodine during dressing changes for active disinfection. Generally, after such treatment, the likelihood of the patient developing tetanus will be minimized.

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Written by Li Xiao Lin
Emergency Department
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Is mild tetanus easy to treat?

Mild tetanus is easy to treat. Mild tetanus presents with slight twitching, numbness in the limbs, and stiffness, with shallow impairment of consciousness and shorter duration of convulsions. Appropriate sedatives or antiepileptic drugs such as midazolam or phenobarbital sodium can be used to control symptoms. Treatment with penicillin to combat tetanus bacillus also yields good results. Additionally, it is important to rest often, avoid excessive fatigue, drink plenty of water, and consume fresh vegetables and fruits. Avoid spicy and irritating foods. (Please use medications under the guidance of a doctor.)

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Written by Xu Jun Hui
General Surgery
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Which part of the body is the tetanus shot administered?

Tetanus injections are given as intramuscular injections in the upper arm or the buttock. Tetanus vaccines include tetanus antitoxin, which requires a skin test. Patients with a positive skin test must either undergo desensitization therapy or avoid using it, and can switch to tetanus immunoglobulin, which doesn't require a skin test but is more expensive than tetanus antitoxin. The purpose of the tetanus shot is to prevent infection by Clostridium tetani, an anaerobic bacterium. It is particularly important for patients with deep wounds or heavily contaminated wounds; or wounds contaminated with rust or soil to receive tetanus treatment to prevent Clostridium tetani from colonizing the body through wound mucosa and producing neurotoxins that affect breathing.

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Written by Xu Jun Hui
General Surgery
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Which department should I go to at the hospital for a tetanus shot?

Tetanus shots should be administered at a regular hospital in the emergency department. There are two types of tetanus injections: one that requires a skin test, called tetanus toxoid, and one that doesn't require a skin test, called tetanus immunoglobulin. It is generally recommended to get the tetanus shot within 24 hours of injury, and it is best to avoid alcohol before the injection. Drinking can cause dilation and reddening of the skin's capillaries, which can affect the results of the tetanus skin test. Tetanus is usually caused by the invasion of Clostridium tetani into the body, a type of anaerobic bacterium. Thus, for wounds that are small, deep, and heavily contaminated, such as with dirt, rust, or in cases of open fractures, anti-tetanus treatment is essential, and a tetanus shot can be administered in the hospital's emergency department.

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Written by Li Xiao Lin
Emergency Department
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How to treat mild tetanus?

The treatment for mild tetanus mainly includes the following aspects: First, to control convulsions, diazepam or midazolam can be administered via muscle injection or intravenous injection. If necessary, phenytoin sodium can be combined to control seizures. If the convulsions last a long time and the symptoms are pronounced, sedative medications can be continuously used to control the convulsions. Second, use large amounts of penicillin and anti-tetanus bacillus treatment to control the infection. Third, maintain a quiet indoor environment to reduce stimuli. Fourth, after the patient regains consciousness, attention should be paid to diet: avoid spicy and stimulating foods, do not smoke or drink alcohol, and it is advised to drink more water and eat more fresh vegetables and fruits. (Please use medication under the guidance of a doctor)

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Written by Zhang Peng
General Surgery
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How is tetanus diagnosed?

For the diagnosis of tetanus, it mainly relies on relevant medical history and clinical manifestations. In terms of laboratory diagnosis, most cases involve culture of Clostridium tetani from wound tissue or polymerase chain reaction testing. Generally, a positive result can confirm a diagnosis of tetanus, but a negative result does not rule it out. Most laboratories are unable to perform these tests, and even if tetanus antibodies reach a protective level, it does not exclude a diagnosis of tetanus. If the patient has a clear history of injury or animal bites, and presents with symptoms such as lockjaw, a sardonic smile, muscle rigidity, difficulty swallowing, or persistent spasms, tetanus should be considered promptly and relevant treatment initiated.