vaccine - curious question

[Soundguy]

Covering all bases? More insurance money??? who knows..

Soundguy

 

[IslandTractor]

He looked at it and said it was definitely a sting, not a bite by a spider or something. He gave her antibiotics, steriods, and a tetanus shot.

Congratulations. You have just received no brainer "shotgun" therapy. No role for either tetanus or antibiotics for a clear insect sting.

 

[N80]

Congratulations. You have just received no brainer "shotgun" therapy. No role for either tetanus or antibiotics for a clear insect sting.

Come on now doc, let's not criticize the guy who was there. Nothing worse than the Ivory Tower guys telling us folks in the trenches how things should be done.

Seriously, we don't know when the last tetanus was. We don't know what stung her or if it was even a sting. Saying it was an insect sting was just the doctors best guess. The skin _was_ penetrated (tetanus booster is even recommened with 2nd degree burns after all.) We don't know how available reliable follow-up would be either. Such a 'shotgun' response is clearly not the 'academic' approach, but it doesn't mean it was the the wrong approach either. In the real world a shotgun approach can be the best and safest approach especially in an urgent care or ER setting. And we all can't be Dr. House, you know.

 

[skent]

my BIL got hit by a rooster, didn't see the doctor. . . . said it was nothin'.

here's a recent photo of him with his dad. . . . . .

 

[IslandTractor]

.. let's not criticize the guy who was there. Nothing worse than the Ivory Tower guys telling us folks in the trenches how things should be done.

Sorry, but we'll have to disagree. Polypharmacy just ain't good medicine. Doesn't matter if you are practicing solo or at a medical center. Why do we have CA MRSA or resistant pneumococcus as issues today?....largely because antibiotics have been abused for the past 30 years or more. My point is simply that if the doc was really even just strongly suspcious much less sure it was a sting (and it sure sounded like a sting and allergic rxn) then antibiotics and tetanus were simply not indicated....watchful waiting would have been more appropriate. The tetanus booster is no big deal but the situation was hardly high risk for tetanus. Part of the problem is that that doc has now started "training" this patient that everytime there is a sting there should be antibiotics and booster shots. Same thing as prescribing antibiotics for a common cold, it estblishes an expectation in the patient that then becomes a time consuming challenge for the next doc who tries to do it right. Wrong message and crappy medicine.

 

[Tom_Veatch]

Oh, GREAT!!!

Now I'm gonna be longer getting that durn tune out of my head than Soundguy was getting the spur outta his back!

Thanks, a lot!!!!

 

[rback33]

Oh, GREAT!!!

Now I'm gonna be longer getting that durn tune out of my head than Soundguy was getting the spur outta his back!

Thanks, a lot!!!!

Since we are near the subject.. I earned my bonhead of the year award yesterday...

lighting my wood stove I was snapping old lath from my house remodel over my knees for kindling... being ver y careful the nails were pointing UP before the THWACK over the knee... see where this is going?

noticed one didn't (seem to) have the usual middle nail as the "THWACK" of snapping wood was replaced bt things I can't type here. I will first go on record as stating I finished the kindling and fire lighting BEFORE hobbling into the kitchen to extricate myself from my boots and jeans. As only a three y/o can do my daughter points out "yer bleeding daddy" (see poke bloody spot, muttering ujnder breath) Here comes "Dr. Mommy" to the rescue with wipe and ointment (wipe 15 time with swab and stick end of ointment tube to the bottom of the hole) Was she trying to kill me? Anyway. I got me a nice puncture just above the right knee... Hurts like he!!... less than 2 yrs from last tetanus shot...and wife sure thought it was funny ...the vastus lateralis and rectis femoris are dang sore though

So... IT... no reason to go to the doc is there? My wife is hoping for an abscess so she can play squeeze it and make it ooze...

 

[patrick_g]

Rust is not a requirement for tetanus. I don't know why folks think rusty nail = tetanus. The organism lives in the environment. If your skin is broken and any environmental material (**** near anything) gets to the wound (even a sting... anything that breaks the skin) you are succeptible to getting tetanus It is a crapshoot. You may or may not be exposed and if exposed you may or may not sucumb. Better safe than sorry. Who can't afford to get a shot at least every 5 years when it could prevent a lot of pain and suffering and possible premature death.=============== Pat

 

[N80]

Sorry, but we'll have to disagree......Wrong message and crappy medicine.

Again, you're making that assessment (and accusation) on very limited info. Again, the poster did not say if she was due for a Td or not, so you don't know if it was given because a bug punctured her skin (wrong reason) or because she was there and needed it as a preventive (good reason). Again, you nor I saw the wound (I've seen countless secondary infections from excoriated mosquito and chigger bites) or the rash or the patient. Again, the cause of the wound was unknown. Again, in a setting in which follow-up is not possible or is unlikely, all the rules change.

We're not really in disagreement in regard to proper use of Td, antibiotics (and I'm sure you've never prescribed a Zpack for marginal diagnosis of sinusitis right? ) or for that matter, corticosteriods and I'm not defending _any_ physicians motives or practice. I'll bust another docs chops any day of the week (and have) if he is practicing bad medicine. But I would never criticize another doctor's work (or anyone else's) when I don't have the necessary facts to justify it. (That's what we have malpractice attorneys for, well, that and keeping the bottom of the pond clean.) And in the case at hand, the facts aren't there. Period.

 

[Bird]

I earned my bonhead of the year award yesterday...

Some good came from it though in that it gave me a good laugh.