Sep 24, 2013

Scot: Is it bad enough to go to the emergency room? Or isn't it? Find out now. This is ER or Not, on The Scope.
All right, it's time for another edition of ER or not with Dr. Troy Madsen, Emergency Physician at the University of Utah Hospital. It's the game that you get to play ER doctor and decide whether or not it's bad enough to go to the ER or not. Are you ready?

Dr. Troy Madsen: I'm ready.

Scot: All right, I was out hiking and I stepped on a rusty nail. ER or not?

Dr. Troy Madsen: Great question. So, the question I would have for you is, "When was the last time you had a tetanus booster?"

Scot: Okay, how long ago should I have had it?

Dr. Troy Madsen: That's the question that always comes up. So the rusty nail itself is probably not going to be an issue. We always think about infection, and if it goes through the sole of your shoe there have been some things out there that have said, well it probably needs to be on antibiotics, just because the sole of your shoe can have some bacteria in it that you might not get exposed to otherwise. So a lot of times we'll err on the side of caution, maybe put you on some antibiotics to prevent infection, but the big thing I think about is, "Do you need a tetanus booster?"
So the limit is ten years, and we always err on the side of caution in the ER just because people's memory may be a little fuzzy. We try and keep that at about five years. If they cannot clearly state, "I've had a tetanus booster within the last five years", then we're going to give that and that would be a reason to go to an ER. It's also one of those things you might be able to go to an urgent care for, but wherever you can get into.

Scot: How serious is it if I have not had a tetanus shot? What could happen?

Dr. Troy Madsen: Tetanus is very serious and tetanus is something that's contained in spores in the dirt, just kind of sits in there. It's when it gets in your skin and into your bloodstream it really causes problems. The big issue with tetanus is if you get tetanus there's not a lot we can do for it. It's very serious, very fatal. That's why we always make sure your tetanus booster is up-to-date to make sure you're not going to get that.
We're your daily dose of science, conversation, medicine. This is The Scope, University of Utah Health Science Radio.

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