From the Guidelines
Tdap vaccination is recommended for snake bite victims if they have not received a tetanus toxoid-containing vaccine within the last 5 years for dirty or high-risk wounds, or 10 years for clean and minor wounds, as per the guidelines outlined in the study by 1. This recommendation is based on the guide to tetanus prophylaxis in routine wound management, which suggests that individuals with wounds, including those from snake bites, should receive a tetanus toxoid-containing vaccine if their vaccination history is incomplete or uncertain [ 1 ]. The study published in MMWR Recommendations and Reports in 2018 [ 1 ] provides a comprehensive guide for tetanus prophylaxis, emphasizing the importance of considering the type of wound and the patient's vaccination history when determining the need for a tetanus booster. Some key points to consider include:
- The type of wound: dirty or contaminated wounds, such as those resulting from snake bites, may require a tetanus booster if the patient's vaccination history is incomplete or uncertain [ 1 ].
- The patient's vaccination history: individuals who have not received a tetanus toxoid-containing vaccine within the recommended timeframe or have an uncertain vaccination history may require a booster dose [ 1 ].
- The use of tetanus immune globulin (TIG): in some cases, TIG may be recommended in addition to the Tdap vaccine, particularly for individuals with contaminated wounds or uncertain vaccination histories [ 1 ].
From the Research
Tdap for Snake Bite
- There is no evidence to suggest that Tdap (tetanus, diphtheria, and pertussis) vaccine is used to treat snake bites 2, 3, 4, 5, 6.
- The treatment for snake bites typically involves the administration of antivenom, which is specific to the type of snake that inflicted the bite 2, 3, 4, 5, 6.
- Supportive care, such as wound cleaning, broad-spectrum antibiotics, and tetanus prophylaxis, may also be provided 4, 6.
- Some studies suggest that pressure immobilization bandages and related strategies may be used to delay the onset of systemic toxicity from venomous snakebites, but their use should be individualized to the circumstances and nature of the venom 5.
Treatment of Snake Bites
- Antivenom is the definitive treatment for venomous snakebites, but it is expensive and not available in many rural and poorly developed regions 5.
- The administration of antivenom should be done intravenously, and skin testing to predict the possibility of anaphylactic reaction is mandatory before administration 4.
- Diphenhydramine and epinephrine should be readily available in case of anaphylaxis 4.
- Fasciotomy is only indicated in rare cases involving elevated intracompartment pressures 4.
First Aid for Snake Bites
- Previously recommended first-aid measures such as tourniquets, incision, and suction are strongly discouraged 2, 5.
- Cryotherapy is contraindicated 4.
- The wound should be cleaned, and broad-spectrum antibiotics should be administered 4, 6.
- Tetanus status should be determined, and tetanus toxoid should be administered if necessary 4, 6.